Infection Control Today - 03/2002: IC Community

Reader Feedback
ICPs Speak Out

Editor's note: In this issue we introduce a new feature called Reader Feedback, where we pose to readers of Infection Control Today questions on timely topics and solicit your responses for publication.

Q: Does your facility prohibit artificial fingernails worn by OR personnel? Do you think they represent an infection control problem?

A: "We do not allow artificial nails due to infection. Years ago, when the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) came through (our facilities) they told us of a case in another state where a patient died of a fungal infection. The patient had chest surgery and the wound would not heal. They did tests and traced it back to the artificial nails of the scrub tech."

Peggy Larkin
Administrator, Greater New Orleans Surgery Center; Metairie, LA

A: "We have always had a policy that we don't wear artificial fingernails in the OR. We are part of a hospital system and we made a system-wide policy that we don't have artificial fingernails in any patient-care areas. That was based on recommendations by the epidemiologists that work at the facilities. They went through committee and there were articles cited and literature to back it up."

Lynn Vandewalle
Director of Quality and Regulatory Compliance, Methodist Healthcare System; San Antonio, TX

A: "Seven months ago we incorporated the following section in our infection control policy to address artificial nails. The policy implementation has been successful.

Artificial Nails, Natural Nails, and Nail Polish:

1. Artificial nails are substances or devices applied to natural nails to augment or enhance nails. They include but are not limited to bonding, tips, wrappings, tapes, and inlays. Because of increased scientific reports linking higher numbers of gram-negative microorganisms and fungi cultured from the fingertips of personnel wearing artificial nails compared to personnel with natural nails and an increased incidence of healthcare-acquired infections, artificial nails should not be worn by:

  • All surgical personnel
  • All staff involved in cleaning processes
  • All direct patient caregivers and by
  • All staff who prepare products for patients

2. Nails should be kept clean. Patient care providers and others listed above must keep their nails short. It is recommended that natural nails be left unpolished. Clear polish is preferable over colored. If polish is worn, it cannot be chipped, cracked, or peeling."

Jodi Vinsel, RN, CIC
Children's Hospital, Inc.; Columbus, OH

A: "We are a small rural community hospital. Our surgery personnel do not wear artificial fingernails. They do not have a written policy specifically prohibiting artificial nails, but they follow national OR nursing guidelines and they all personally feel that it is not a good thing for the surgery department."

Gretchen Downer, MT (ASCP)
Chairman, Infection Control Committee, Walter Knox Memorial Hospital; Emmett, ID

A: "Our facility's policy does not permit artificial fingernails in the OR. The AORN 'Recommended Practices for Surgical Hand Scrubs' and 'Recommended Practices for Surgical Attire' Standards states, 'Artificial nails should not be worn.' I believe artificial nails may harbor organisms and inhibit thorough cleansing. Artificial nails also create a risk of puncturing gloves during surgical procedures. Nurses must be advocates of quality patient care. We should practice standards that enhance the healing process instead of creating an environment that may hinder the patients' well being. I feel preventive measures must be taken to provide the safest environment for patient healing. We are now facing an era of antibiotic-resistant organisms; therefore, we must prevent or reduce the risk of infection for our patients. We should practice standards that limit complications for our patients, thus not allowing employees to wear artificial nails. I also feel all patient-contact areas should implement this practice to limit the potential of infections for patients."

Donna B. Sessoms, RNFA, CNOR
OR Manager, Chatham Hospital, Inc.; Siler City, NC

A: "OR personnel are prohibited from wearing artificial nails. I believe they pose an infection control issue. A couple of people here have suffered from terrible nail fungus infections while wearing sculpted nails. This has been an issue for several years. Even real nails have been an issue if they are too long. Why take the chance of passing on an organism that may have been hiding under the nail? This is my personal feeling. The nurses have not given us a difficult time. The OR nail policy is a department-specific policy."

Webbie Calhoun, RN
Infection Control/Employee Health, Selma Regional Medical Center; Selma, AL

We enjoy hearing from our readers and finding out what is important to them. If you would like to give us your feedback on this upcoming question, e-mail your responses to Be sure to include your name, title, and facility name, and type the question in the subject line of the e-mail. The deadline for May's responses is Friday, March 22.

May's question is:
"How can healthcare workers best curtail hospital-acquired infections?"

Compiled by Michelle Gardner


Germs: Biological Weapons and America's Secret War
By Judith Miller, Stephen Engelberg, and William Broad
Simon & Schuster, 2001; 384 pages
ISBN: 0-684-87158-0

While not every infection control practitioner or healthcare professional will ever come face-to-face with the likes of anthrax or tularemia, in light of the events of Sept. 11 it may be wise to brush up on your knowledge of deadlier pathogens. In Germs, investigative journalists Miller, Engelberg, and Broad have dug up the dirt on bioterrorism and its earliest threats to national security and public health. While the book focuses on covert government and military actions taken to thwart the threats of biological warfare, clinicians will find Germs to be a fascinating and instructive journey throughout the more frightening aspects of renegade pathogens and epidemiology-gone-bad.


World of Germs: Germs Are Found Everywhere
By Andy Pitas

Glo Germ Company will soon make available an amusing musical CD filled with clever ditties about bacteria that will have you tapping your toes at your next in-service on avoiding infectious agents. Following the styles of everything from country western, opera and patriotic music, World of Germs offers such soundbites as "Septic River," "Battle Hymn of the Rat Flea," and odes to malaria, pneumonia, botulism, E. coli, Staphyloccoccus, and Streptococcus.

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