Home Health & Hospice

Artificial Fingernails Present a Danger to Patients and Staff

Homecare Insider, June 15, 2009

Many homebound patients are at high risk for infection because of drug therapy and diseases that weaken the immune system, invasive devices such as feeding tubes or catheters, extreme age, and more.  It is possible that a homecare worker’s artificial fingernails could spread infection to these patients.

Many studies have shown a correlation between bacteria that cause infections in patients and the organisms cultured from the hands of healthcare workers.  For example, one study found that 12 of 56 nurses (21 percent) with artificial nails had more than 100 colony-forming units of gram-negative rods after washing their hands.  Only 5 percent of the control group had these organisms.

Long nails, whether artificial or not, are more likely to penetrate gloves and put the homecare worker at risk for exposure to blood and other body fluids.  A healthcare worker with minor damage and the start of an infection around the nails (usually related to a nail breaking) can transmit infection to a patient.  And damaged skin around nails makes the worker more vulnerable to picking up an infection.

Besides the risk of infection transmission, the use of artificial nails can:
• jeopardize the health and integrity of the nail bed
• lead to nail and skin damage caused by the chemicals used in applying and removing nails, and
• expose the wearer to toxic chemicals used in the process.

The Centers for Disease Control and Prevention (CDC) recommends that healthcare providers not wear artificial fingernails or extenders when having direct contact with patients at high risk.  The best and safest advice:  Keep nails short, well groomed, and polish free.  

Read the CDC’s “Guideline for Hand Hygiene in Health-Care Settings” at — click here .  And check out Bloodborne Pathogens:  Protecting Yourself and Others in Homecare.