Banning artificial nails from health care settings

Abstract

It has been increasingly appreciated that artificial nails worn by health care workers (HCWs) can contribute to health care-associated infections. Compared with natural nails, artificial nails have higher rates of colonization with gram-negative flora and yeast. 1-4 However, unchipped nail polish applied to natural nails is not associated with increased colonization with micro-organisms.4 More recently, there have been increasing reports linking artificial nails to nosocomial infections. These have included outbreaks due to gram-negative bacilli such'as Pseudomonas aeruginosa, 5,6 Serratia marscescens, 7 Klebsiella pneumoniae (Gupta et al. 8 ), and Candida albicans. 9 As a result, the Association of Peri-Operative Registered Nurses strongly discourages the use of artificial nails. 10 The draft guidelines from the Hospital Infection Control Practices Advisory Committee for hand hygiene grade the elimination of artificial nails from the hands of HCWs as Category 1A; guidelines in this category are strongly recommended and strongly supported by well-designed experimental, clinical, or epidemiologic studies (E. Larson, personal communication, March 21, 2002).