[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
>
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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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