Wearing of Nail Polish, Acrylic nails, SNS, Shellac on Nurses providing Clinical Care Studies

[tracey.wood@healthecare.com.au]

Hello all,

I am having a hard time to get some nurses to adhere to below the elbows in regards to Nail Polish, Enhancements, SNS, Shellac etc.
Most of the staff say that because its Shellac or SNS, it doesn’t chip and become a hazard.
I have given them our policies to support this fact of removal all nail enhancements.

Does anyone know of any recent studies on this topic that I read to get more information to supply to my staff?

Thanks,
Tracey Wood
Regional Infection Control Coordinator
Gosford Private Hospital
[Description: hca_luye_logo]
Burrabil Avenue, North Gosford NSW 2250, Australia
T +61 2 4348 8511 F +61 2 4323 8118
E tracey.wood@healthecare.com.au W healthecare.com.au

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[stephen s]

Hello Tracey,

I’d like to point you to a few recent resources that may be helpful. Please
note that this is by no means comprehensive, and should not be taken as
concrete advice on how to proceed (especially given my junior status). *This
is explicitly not the advice or opinion of the ACIPC.*

1. In 2017, the Canadian Agency for Drugs and Technologies in Health
(CADTH) released a summary and critical appraisal of current (at the time)
clinical evidence and guidelines regarding jewellery and nail polish in a
surgical setting.
– https://europepmc.org/books/n/rc0858/pdf/
– It agrees that the* probable* safest option for HH is to have*
no polish or jewellery whatsoever,* but acknowledges the lack of rigorous
peer-reviewed research on the topic, and the* level of evidence is not
particularly strong.*

2. An study for publication in the March 2020 issue of the Oncology Nursing
Forum aimed to measure bacterial burden of regular nail polish, with
interesting results.
–
https://pdfs.semanticscholar.org/ed52/788557a0567540f32a0deb0cbd8f185e7710.pdf
– The study concludes that the optimal strategy for infection
control is to *not wear nail polish or other nail coverings at all*.
– The study did find that for 24 hours after application, the
bacterial burden of the polished nail was less than unpolished, but returns
to baseline around day 4.
– The cause of the 24-hour “grace period” was not identified in
this study.
– Chipped nails produced a universal increase in bacterial
burden, and 100% of participants had chipped nails by day 4.
– The study does *not* correlate bacterial load of nails with the
incidence of HCAIs.

3. A 2018 study published in the American Journal of Infection Control
aiming to measure bacterial burden of various nail types for healthcare
workers.
–
https://www.sciencedirect.com/science/article/abs/pii/S0196655318306746
– The study found that bacterial burden for all nail types
increased over time and found *minimal difference in baseline bacterial
burden* of all nail types (741 nail samples).
– Incidental finding that *gel nails responded poorly to
alcohol-rub hand hygiene* compared to regular polish and unpolished nails,
having a larger retention of bacteria than the others.
– The study *did not differentiate between shellac and SNS* –
referring to all gel-based nail products as “gel nails”.

I will continue to seek out and review relevant studies, but literature
specific to the microbiomes of painted nails is surprisingly limited.

Warm regards,

Stephen Sparkham
Registered Nurse, Bunbury Regional Hospital
*MNursSci, BSc (Microbiology, Pathology)*

On Fri, Feb 28, 2020 at 1:05 PM Wood, Tracey
wrote:

> Hello all,
>
>
>
> I am having a hard time to get some nurses to adhere to below the elbows
> in regards to Nail Polish, Enhancements, SNS, Shellac etc.
>
> Most of the staff say that because its Shellac or SNS, it doesnt chip and
> become a hazard.
>
> I have given them our policies to support this fact of removal all nail
> enhancements.
>
>
>
> Does anyone know of any recent studies on this topic that I read to get
> more information to supply to my staff?
>
>
>
> Thanks,
>
> *Tracey Wood*
> Regional Infection Control Coordinator
> *Gosford Private Hospital*
>
> [image: Description: hca_luye_logo]
>
> Burrabil Avenue, North Gosford NSW 2250, Australia
> *T* +61 2 4348 8511 *F* +61 2 4323 8118
> *E* tracey.wood@healthecare.com.au *W* healthecare.com.au
>
> Disclaimer: This email, which includes information and data located in any
> attachments, links, portals or associated interface, is private and
> confidential and is intended only for the use of the addressee(s) named
> above. This email may contain information that is privileged, commercial in
> confidence, private or subject to copyright and other intellectual property
> rights. If you are not the intended recipient of this message you are
> hereby notified that you must not disseminate, copy or take any action or
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> “personal Information” or “sensitive information” contained in this email
> is subject to the Privacy Act 1988 (Cth) and any prohibited use of such
> information may result in severe penalties being imposed. If you received
> this message in error please notify Healthe Care Australia immediately and
> delete and destroy the email from your computer.
> MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO
> NOT REPRESENT THE OPINION OF ACIPC.
>
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MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

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[robertsh@sath.org.au]

Hi Tracey,
I have the same issue with staff saying that Shellac is safe to wear when it comes to hand hygiene.
I would like to be included in any information in regards to this please.

Regrds,
Helen

Helen Roberts
Infection Control
P: 07 4646 3106 |
F: 07 4633 7602
E: robertsh@sath.org.au |
W: http://www.sath.org.au
________________________________

Hello all,

I am having a hard time to get some nurses to adhere to below the elbows in regards to Nail Polish, Enhancements, SNS, Shellac etc.

Most of the staff say that because its Shellac or SNS, it doesnt chip and become a hazard.

I have given them our policies to support this fact of removal all nail enhancements.

Does anyone know of any recent studies on this topic that I read to get more information to supply to my staff?

Thanks,

Tracey Wood
Regional Infection Control Coordinator
Gosford Private Hospital

[Description: hca_luye_logo]

Burrabil Avenue, North Gosford NSW 2250, Australia
T +61 2 4348 8511 F +61 2 4323 8118
E tracey.wood@healthecare.com.au W healthecare.com.au

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

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[Barbara Hayes]

Hi Tracey and Helen,

We also have this issue (and staff argument) in dental – I too would
greatly appreciate being included in any information please.

Kind regards
Barbara

On Sun, Mar 1, 2020 at 3:01 PM Helen Roberts wrote:

> Hi Tracey,
> I have the same issue with staff saying that Shellac is safe to wear when
> it comes to hand hygiene.
> I would like to be included in any information in regards to this please.
>
> Regrds,
> Helen
>
> Helen Roberts
> Infection Control
> P: *07 4646 3106* |
> F: *07 4633 7602*
> E: *robertsh@sath.org.au* |
> W: *www.sath.org.au*
> Post: PO Box 263, Toowoomba, QLD 4350
> Address: 280 North St, Toowoomba, QLD 4350
>
> ——————————
> *From:* ACIPC Infexion Connexion on behalf of
> Wood, Tracey
> *Sent:* Friday, 28 February 2020 2:36 PM
> *To:* ACIPCLIST@ACIPC.ORG.AU
> *Subject:* [ACIPC_Infexion_Connexion] Wearing of Nail Polish, Acrylic
> nails, SNS, Shellac on Nurses providing Clinical Care Studies
>
>
> Hello all,
>
>
>
> I am having a hard time to get some nurses to adhere to below the elbows
> in regards to Nail Polish, Enhancements, SNS, Shellac etc.
>
> Most of the staff say that because its Shellac or SNS, it doesnt chip and
> become a hazard.
>
> I have given them our policies to support this fact of removal all nail
> enhancements.
>
>
>
> Does anyone know of any recent studies on this topic that I read to get
> more information to supply to my staff?
>
>
>
> Thanks,
>
> *Tracey Wood*
> Regional Infection Control Coordinator
> *Gosford Private Hospital*
>
> [image: Description: hca_luye_logo]
>
> Burrabil Avenue, North Gosford NSW 2250, Australia
> *T* +61 2 4348 8511 *F* +61 2 4323 8118
> *E* tracey.wood@healthecare.com.au *W* healthecare.com.au
>
> Disclaimer: This email, which includes information and data located in any
> attachments, links, portals or associated interface, is private and
> confidential and is intended only for the use of the addressee(s) named
> above. This email may contain information that is privileged, commercial in
> confidence, private or subject to copyright and other intellectual property
> rights. If you are not the intended recipient of this message you are
> hereby notified that you must not disseminate, copy or take any action or
> assist any third party to take any action based on its contents. Any
> “personal Information” or “sensitive information” contained in this email
> is subject to the Privacy Act 1988 (Cth) and any prohibited use of such
> information may result in severe penalties being imposed. If you received
> this message in error please notify Healthe Care Australia immediately and
> delete and destroy the email from your computer.
> MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO
> NOT REPRESENT THE OPINION OF ACIPC.
>
> The use of trade/product/commercial brand names through the list is
> discouraged by ACIPC. If you wish to discuss specific reference to products
> or services by brand or commercial names, please do this outside the list.
>
> Archive of all messages are available at http://aicalist.org.au/archives
> – registration and login required.
>
> Replies to this message will be directed back to the list. To create a new
> message send an email to acipclist@acipc.org.au
>
> To send a message to the list administrator send an email to
> admin@acipc.org.au
>
> You can unsubscribe manually from this list by sending ‘signoff acipclist’
> (without the quotes) to listserv@aicalist.org.au
> MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO
> NOT REPRESENT THE OPINION OF ACIPC.
>
> The use of trade/product/commercial brand names through the list is
> discouraged by ACIPC. If you wish to discuss specific reference to products
> or services by brand or commercial names, please do this outside the list.
>
> Archive of all messages are available at http://aicalist.org.au/archives
> – registration and login required.
>
> Replies to this message will be directed back to the list. To create a new
> message send an email to acipclist@acipc.org.au
>
> To send a message to the list administrator send an email to
> admin@acipc.org.au
>
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> (without the quotes) to listserv@aicalist.org.au
>

—

*Barba**r**a Hayes*

*Dental Assistants Professional Assoc.*

4/116 Percival Road, Stanmore, NSW 2048

PO Box 40, Westgate, NSW 2048

*T/F: *(0)2 9569 3220 *M: *0411 069 921

*E: *bhayes@dapa.asn.au *W: *www.dapa.asn.au

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[Angela Carvosso]

Hello ladies,

I did a lit review on this for uni. The most recent study I found was
Hewlett, A. L., Hohenberger, H., Murphy, C. N., Helget, L., Hausmann, H., Lyden, E., . . . Hicks, R. (2018). Evaluation of the bacterial burden of gel nails, standard nail polish, and natural nails on the hands of health care workers. AJIC: American Journal of Infection Control, 46(12), 1356-1359. doi:10.1016/j.ajic.2018.05.022
I would ask the staff members to show the scientific literature they are basing their statements on. Irrespective of that, if the policy is bare then bare it must be. When they sign their employee agreement they agree to abide by policy and procedure, you might point that out to them.

Regards
Angela Carvosso
Registered Nurse
Warwick Health Service
Sent from Mail for Windows 10

From: Helen Roberts
Sent: Sunday, 1 March 2020 2:01 PM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Wearing of Nail Polish, Acrylic nails, SNS, Shellac on Nurses providing Clinical Care Studies

Hi Tracey,
I have the same issue with staff saying that Shellac is safe to wear when it comes to hand hygiene.
I would like to be included in any information in regards to this please.

Regrds,
Helen
Helen Roberts
Infection Control
P:
07 4646 3106
|
F:
07 4633 7602
E:
robertsh@sath.org.au
|
W:
http://www.sath.org.au
Post:
PO Box 263, Toowoomba, QLD 4350
Address:
280 North St, Toowoomba, QLD 4350
[cid:image771988.jpg@E7691CDC.A903A80C]

From: ACIPC Infexion Connexion on behalf of Wood, Tracey
Sent: Friday, 28 February 2020 2:36 PM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: [ACIPC_Infexion_Connexion] Wearing of Nail Polish, Acrylic nails, SNS, Shellac on Nurses providing Clinical Care Studies

Hello all,

I am having a hard time to get some nurses to adhere to below the elbows in regards to Nail Polish, Enhancements, SNS, Shellac etc.

Most of the staff say that because its Shellac or SNS, it doesnt chip and become a hazard.

I have given them our policies to support this fact of removal all nail enhancements.

Does anyone know of any recent studies on this topic that I read to get more information to supply to my staff?

Thanks,

Tracey Wood
Regional Infection Control Coordinator
Gosford Private Hospital

[Description: hca_luye_logo]

Burrabil Avenue, North Gosford NSW 2250, Australia
T +61 2 4348 8511 F +61 2 4323 8118
E tracey.wood@healthecare.com.au W healthecare.com.au

Disclaimer: This email, which includes information and data located in any attachments, links, portals or associated interface, is private and confidential and is intended only for the use of the addressee(s) named above. This email may contain information that is privileged, commercial in confidence, private or subject to copyright and other intellectual property rights. If you are not the intended recipient of this message you are hereby notified that you must not disseminate, copy or take any action or assist any third party to take any action based on its contents. Any “personal Information” or “sensitive information” contained in this email is subject to the Privacy Act 1988 (Cth) and any prohibited use of such information may result in severe penalties being imposed. If you received this message in error please notify Healthe Care Australia immediately and delete and destroy the email from your computer.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

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[Glenys Harrington]

Hi Tracey,

Artificial acrylic nails have been shown to harbor higher frequencies of potential pathogens after alcohol hand rub and after antimicrobial soaps. Artificial acrylic nails & fungal infection often occurs with poorly fitted acrylic nails or any disturbance to the original fit (i.e. warmth, moisture and darkness) which affects the skin under the nail and skin around the nail.

Sherner et al showed the following:

*68 pts suffering from nail changes and paronychia which appeared after removal of artificial nails
*Culture was positive in 67 patients (98.5%)
*Candida spp. were the most common pathogen

Shemer A et al. Onycomycosis due to artificial nails. J Eur Acad Dermatology Venereol. 2008 Aug;22(8):998-1000

Despite artificial acrylic nails being epidemiologically implicated in several outbreaks (i.e. Serratia marcesans, Pseudomonas aeruginosa,Candida spp) I understand the finding were inconclusive in relation to what came first:

a.nail contamination which resulted in patient infection/colonisation/outbreak or
b.patient infection/colonisation which resulted in HCW hand/nail contamination

I dont get too caught up in these types of issues (i.e. artificial nails, nail polish) unless Im investigating an outbreak and can establish an epidemiological links. Such issues can take up a lot of an ICPs time when there are probably more pressing issues we could focus our limited resources on.

Below the elbows another recently introduced infection control strategy that is controversial and lacks evidence to support the practice.

Hope this is helpful.

Regards

Glenys

Glenys Harrington

Consultant

Infection Control Consultancy (ICC)

P.O. Box 6385

Melbourne

Australia, 3004

M: +61 404816434

E: infexion@ozemail.com.au

Hello ladies,

I did a lit review on this for uni. The most recent study I found was

Hewlett, A. L., Hohenberger, H., Murphy, C. N., Helget, L., Hausmann, H., Lyden, E., . . . Hicks, R. (2018). Evaluation of the bacterial burden of gel nails, standard nail polish, and natural nails on the hands of health care workers. AJIC: American Journal of Infection Control, 46(12), 1356-1359. doi:10.1016/j.ajic.2018.05.022

I would ask the staff members to show the scientific literature they are basing their statements on. Irrespective of that, if the policy is bare then bare it must be. When they sign their employee agreement they agree to abide by policy and procedure, you might point that out to them.

Regards

Angela Carvosso

Registered Nurse

Warwick Health Service

Sent from Mail for Windows 10

Hi Tracey,

I have the same issue with staff saying that Shellac is safe to wear when it comes to hand hygiene.

I would like to be included in any information in regards to this please.

Regrds,

Helen

Helen Roberts

Infection Control

P:

07 4646 3106

|

F:

07 4633 7602

E:

robertsh@sath.org.au

|

W:

http://www.sath.org.au

PO Box 263, Toowoomba, QLD 4350

280 North St, Toowoomba, QLD 4350

Hello all,

I am having a hard time to get some nurses to adhere to below the elbows in regards to Nail Polish, Enhancements, SNS, Shellac etc.

Most of the staff say that because its Shellac or SNS, it doesnt chip and become a hazard.

I have given them our policies to support this fact of removal all nail enhancements.

Does anyone know of any recent studies on this topic that I read to get more information to supply to my staff?

Thanks,

Tracey Wood
Regional Infection Control Coordinator
Gosford Private Hospital

Burrabil Avenue, North Gosford NSW 2250, Australia
T +61 2 4348 8511 F +61 2 4323 8118
E tracey.wood@healthecare.com.au W healthecare.com.au

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

Replies to this message will be directed back to the list. To create a new message send an email to acipclist@acipc.org.au

To send a message to the list administrator send an email to admin@acipc.org.au

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The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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