Infection Control Today - 03/2002: IC Community

March 1, 2002

Reader Feedback ICPs Speak Out

Reader Feedback
ICPs Speak Out

Editor'snote: In this issue we introduce a new feature called Reader Feedback, wherewe pose to readers of Infection Control Today questions on timely topics andsolicit your responses for publication.

Q: Does your facility prohibit artificial fingernails worn by ORpersonnel? 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 apatient died of a fungal infection. The patient had chest surgery and the woundwould not heal. They did tests and traced it back to the artificial nails of thescrub tech."

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

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

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

A: "Seven months ago we incorporated the following section in ourinfection control policy to address artificial nails. The policy implementationhas been successful.

Artificial Nails, Natural Nails, and Nail Polish:

1. Artificial nails are substances or devices applied to natural nails toaugment or enhance nails. They include but are not limited to bonding, tips,wrappings, tapes, and inlays. Because of increased scientific reports linkinghigher numbers of gram-negative microorganisms and fungi cultured from thefingertips of personnel wearing artificial nails compared to personnel withnatural 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 abovemust keep their nails short. It is recommended that natural nails be leftunpolished. Clear polish is preferable over colored. If polish is worn, itcannot be chipped, cracked, or peeling."

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

A: "We are a small rural community hospital. Our surgerypersonnel do not wear artificial fingernails. They do not have a written policyspecifically prohibiting artificial nails, but they follow national OR nursingguidelines and they all personally feel that it is not a good thing for thesurgery department."

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

A: "Our facility's policy does not permit artificial fingernailsin the OR. The AORN 'Recommended Practices for Surgical Hand Scrubs' and'Recommended Practices for Surgical Attire' Standards states, 'Artificial nailsshould not be worn.' I believe artificial nails may harbor organisms and inhibitthorough cleansing. Artificial nails also create a risk of puncturing glovesduring surgical procedures. Nurses must be advocates of quality patient care. Weshould practice standards that enhance the healing process instead of creatingan environment that may hinder the patients' well being. I feel preventivemeasures must be taken to provide the safest environment for patient healing. Weare now facing an era of antibiotic-resistant organisms; therefore, we mustprevent or reduce the risk of infection for our patients. We should practicestandards that limit complications for our patients, thus not allowing employeesto wear artificial nails. I also feel all patient-contact areas should implementthis 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. Ibelieve they pose an infection control issue. A couple of people here havesuffered from terrible nail fungus infections while wearing sculpted nails. Thishas been an issue for several years. Even real nails have been an issue if theyare too long. Why take the chance of passing on an organism that may have beenhiding under the nail? This is my personal feeling. The nurses have not given usa 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-mailyour responses to mgardner@vpico.com. Besure to include your name, title, and facility name, and type the question inthe subject line of the e-mail. The deadline for May's responses is Friday,March 22.

Compiled by Michelle Gardner

Books

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

Whilenot every infection control practitioner or healthcare professional will evercome face-to-face with the likes of anthrax or tularemia, in light of the eventsof Sept. 11 it may be wise to brush up on your knowledge of deadlier pathogens.In Germs, investigative journalists Miller, Engelberg, and Broad have dugup the dirt on bioterrorism and its earliest threats to national security andpublic health. While the book focuses on covert government and military actionstaken to thwart the threats of biological warfare, clinicians will find Germsto be a fascinating and instructive journey throughout the more frighteningaspects of renegade pathogens and epidemiology-gone-bad. www.simonsays.com

CDs

World of Germs: Germs Are Found Everywhere
By Andy Pitas

GloGerm Company will soon make available an amusing musical CD filled with cleverditties about bacteria that will have you tapping your toes at your nextin-service on avoiding infectious agents. Following the styles of everythingfrom country western, opera and patriotic music, World of Germs offerssuch soundbites as "Septic River," "Battle Hymn of the RatFlea," and odes to malaria, pneumonia, botulism, E. coli, Staphyloccoccus,and Streptococcus. www.glogerm.com

Want to share information about a new infection control-related trainingmaterial or resource? Email to kpyrek@vpico.com