Research for infection protection

Risks of infection in healthcare settings due to artificial nails

Risks of infection in healthcare settings due to artificial nails
In health care, it is often discussed whether artificial or polished nails are a threat to hygienic. In several studies, artificial nails have been shown to pose a risk of infection for patients.

Two different case reports confirm this:

  • The outbreak of P. aeruginosa in a neonatal intensive care unit could be attributed to two nurses with long and artificial nails, respectively [1].
  • The outbreak of Serratia marcescens in a dialysis unit was linked to the artificial nails of a nurse [2].

According to the Robert Koch-Institute (RKI), the risk of infection is because of not completely sealed edges and tiny (moisture) chambers underneath the artificial nails, promoting colonisation of pathogens and thus being a source of infection [3].

Also polished nails can provide pathogens with niches due to cracks in the polish or poor cleaning of risk areas such as under the nails. In addition, polished nails may impair a hand disinfection’s efficacy.

Conclusion for clinical practice

For infection protection reasons healthcare workers treating or caring for patients/residents should not wear artificial nails or have them polished.
Employees acting contrary to these recommendations are a liability risk for healthcare facilities. This hygiene shortcoming is a fully controllable risk.

1. Robert Koch-Institut: Künstliche Fingernägel im Gesundheitsdienst,, last update 11 October 2007.
2. CDC: Guidelines for Hand Hygiene in Health-Care Settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEAAPICIDSA Hand Hygiene Task Force, Octobre 25, 2002 / 51(RR16); 1–44.
3. Gordin F et al. (2007) Infection Control and Hospital Epidiomology 28: 743–744.
4. Bundesgesundheitsblatt – Gesundheitsforschung – Gesundheitsschutz: Händehygiene. Mitteilung der Kommission für Krankenhaushygiene und Infektionsprävention am Robert Koch-Institut. Springer Verlag 2000, 43:230-233.