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Microbial Growth on the Nails of Direct Patient Care Nurses Wearing Nail Polish

Lisa Blackburn
Kelly Acree
Judith Bartley
Elizabeth DiGiannantoni
Elizabeth Renner
Loraine T. Sinnott
ONF 2020, 47(2), 155-164 DOI: 10.1188/20.ONF.155-164

Objectives: To determine whether nurses wearing nail polish pose a greater infection risk to patients than nurses who are not wearing nail polish.

Sample & Setting: 89 direct patient care oncology nurses at a large midwestern National Cancer Institute–designated comprehensive cancer center.

Methods & Variables: The investigators assigned participants’ three middle fingers of their dominant hand to three groups: no nail polish, one-day-old polish, and four-day-old polish at the time of culture. Standard nail polish was applied using a consistent technique. Participants were required to work a shift immediately prior to nail cultures and practice routine hospital hand hygiene. Bacterial cultures were obtained from the nonpolished nail and the polished nails when the polish was one day old and four days old.

Results: Comparison of colony-forming units revealed that one-day-old polish exhibited fewer gram-positive microorganisms than the unpolished nail (p = 0.04). The four-day-old polish showed significantly more microorganisms than the one-day-old polish (p = 0.03). The same trend was demonstrated for gram-negative microorganisms, but the difference was not statistically significant (p = 0.3 and p = 0.17, respectively).

Implications for Nursing: The results should be interpreted and applied to expert nursing practice in the care of vulnerable patient populations. Each institution and practitioner should make their own decisions and interpretation of evidence into practice.

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