Artificial Nails & Nosocomial Infection

Nosocomial infections are infections acquired in a hospital, according to the website Medicine Net. Because many of the microbes that grow in hospitals have developed resistance to treatment, and hospital patients tend to have compromised immune systems, nosocomial infections are very common. Numerous studies suggest that health care workers with artificial nails increase the risk of nosocomial infections in patients.

Considerations

• According to Andrew Pollack's 2010 article on gram-negative nosocomial infections for the New York Times, the CDC estimates that there are 1.7 million hospital-associated infections in the US each year. These infections cause or contribute to 99,000 deaths annually. Pollack further noted that European studies show that two-thirds of deaths due to nosocomial infections are caused by gram-negative bacteria, the same category of microbe found on the fingertips of artificial nail wearers.

Facts

• According to the Centers for Disease Control (CDC) Guideline for Hand Hygiene in Health-Care Settings, health care workers with artificial nails are more likely to carry gram-negative bacteria on their fingertips. (Resource 3, page 29) A 1989 study published in the American Journal of Infection Control noted that higher quantities of gram-negative bacteria are present in those with artificial nails even after handwashing. Although no broad-based studies link the increased bacteria under artificial nails to higher rates of nosocomial infection, the CDC links specific hospital outbreaks of infection to personnel wearing artificial nails.

Risks

• In a 2002 article in the Journal of Pediatric Nursing on artificial nails and patient risk, author A. Toles stated that poor handwashing practices in those with artificial nails might be among the causes of higher bacteria colony counts. Toles also noted that health care workers with longer artificial nails are more at risk of tearing gloves and exposing their patients to nosocomial infections, especially in a surgical situation.

Controversy

• In his 2001 article for the journal Dermatology Online, Edward Jackson argues that health authorities unfairly blame artificial nails for a higher risk of nosocomial infection. He cites an instance of nosocomial infection in which the bacteria were transmitted from an infected jar of hand cream. The editor of the Dermatology Online Journal notes, however, implies that Jackson's argument may be biased by his role as consultant for the American Beauty Association's Nail Manufacturers' Council.

Protocols

• Many hospitals and infectious disease control authorities forbid health care workers to wear artificial nails. According to Johns Hopkins Hospital's online infection control protocol on hand hygiene, no individual who handles sterile supplies or has hands-on contact with patients can wear artificial nails. The Riverside County Regional Medical Center Infection Control 2004 Update on Artificial Nails states that no hospital employees are to wear artificial nails, regardless of their position at the hospital.