I have been carrying out infection control audits and training for the last few months and one of the recurring themes with clinical workers, is hand and wrist Jewellery, artificial nails and pretty coloured nail polish, and the lengths people will go to so they don't have to remove it when working clinically.
There is evidence that skin under rings may be more heavily colonized with microorganisms than the rest of the hand, and that rings and long nails also increase the risk of glove tears. Nail polish and artificial nails have been shown to foster the presence of microorganisms also, which resist removal by hand-washing. The NZ Dental Council Standards on Infection Prevention and Control clearly states... "ensure your forearms are uncovered while practicing hand hygiene techniques" and later goes on to say "refrain from wearing nail polish, nail jewellery, artificial nails, and jewellery on the hands or arms."
All jewellery should be removed from the elbow down, nails should be short, clean and free from polish.
So if we know what we should do, why do we try so hard to find ways around it, and in the process reduce the effectiveness of good good hand hygiene? For the acrylic, gels and nail polish it seems its a fashion statement that in some cases the cost means you want to get good value by keeping it on for as long as possible, though chipped polish doesn't look great either, yet it isn't always removed.
Now jewellery for the large part, is a whole different motivation. Often engagement & wedding rings hold significant emotional attachment and the owners of these beautiful sparkly symbols of love and future plans are much harder to get removed. So covering it up with tape or a plaster will help with keeping the area clean when hand-washing & I wont have to take it off ... right? Wrong, think again, it just creates another trap for microorganisms to hide out and cling too, as shown in the picture attached.
My Infection Control training is a great time to test how well hand-washing really works and identify any shortfalls as I was able to demonstrate with this simple exercise.
Good hand hygiene is crucial in any clinical environment and if preformed correctly, significantly reduces the chances of cross infection. So lets all play our part and comply with the regulations by removing all jewellery below the elbow and make sure our nails are short, clean and free for any polish, gel or acrylic.