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Nail Clinic: Health Care Professionals
The life of a health care professional includes a seemingly endless line of protocol, and in the last few years the Centers for Disease Control (CDC) issued specific guidelines for how health care professionals can wear their nails, which means—among other things—no artificial enhancements. To protect patient safety, health care workers are restricted from wearing long or artificial nails due to the risk of spreading bacteria. Despite the strict regulations, health care professionals can still be some of your most regular clientele. Learn what services you can provide to these clients and how to lure them into your salon.
Rules and Regulations
In October 2002, the CDC’s Healthcare Infection Control Practice Advisory Committee (HICPAC) recommended in its hand hygiene guidelines that “health care personnel should avoid wearing artificial nails and keep natural nails no longer than one-quarter of an inch long if caring for patients at high-risk of acquiring infections.” This guideline was classified with a 1A recommendation rating—the strongest recommendation that the CDC issues. Then in 2003, the CDC launched the Campaign to Prevent Antimicrobial Resistance in Healthcare Settings. The campaign released a brochure called 12 Steps to Prevent Antimicrobial Resistance Among Surgical Patients, which includes a directive for hand hygiene that states: “Do not operate with artificial nails when having direct contact with patients at high risk (e.g. those in intensive-care units or operating rooms).”
But why are enhancements—and even natural nails—so risky for patient care? Mark E. Rupp, M.D., professor of Infectious Diseases at the University of Nebraska Medical Center, says that artificial nails and long natural nails are more likely to carry disease-causing microorganisms because they’re difficult to clean properly.
“We found in our own studies on hand hygiene and hand microbiology that health care workers who have nails longer than two millimeters tend to harbor significantly greater numbers of microorganisms and different species of microorganisms,” Rupp says. “Essentially, if you hold your hand up with the palm facing you and can see the fingernail extending over the top of your finger, then it’s too long for optimum hand hygiene and safe patient care.”
Kenneth B. Gerenraich, D.P.M., CEO and founder of Woodward Laboratories, says that if there are germs to be found on the hands or feet, the bulk will inevitably be under the tips or free edges of nails. “When germs enter our bodies to cause disease and infection, it must be through a portal of entry, whether it’s an eye, ear, nose, mouth, cut, incision or any other bodily orifice,” Gerenraich says. “When the germs enter through these ‘portals,’ they mostly come from the fingertip. We do not use the back of our hand or palms to eat or scratch or blow our noses,” he explains. “The nails catch all sorts of germs and debris, and are the place where these germs mostly reside.”
Therefore, 90% of all germs found on hands are located under the nails, explains Fay Suffin Shinder, RN, director of Regulatory Affairs and manager of Quality Control and Safety for Woodward Laboratories. Outbreaks of infection due to artificial nails or poor hand hygiene practices are commonly documented in medical literature. “There have been documented deaths in a Neonatal ICU (Intensive Care Unit) attributed to nurses with artificial nails,” says Shinder. Rupp points out another example, where there was a case of an outbreak of yeast infections in spinal surgery patients—the result of artificial nails that weren’t properly cleaned. “As a result, almost all operating rooms require that personnel not wear any kind of nail enhancement or polish. And operating room pre-op (preoperative) scrub products now include a nail stick to clean under the nails,” states Shinder.