Effect of Hand Cleansing with Antimicrobial Soap or Alcohol-
Gel on Microbial Colonization of Artificial Fingernails Worn
Part I: Introduction
The purpose of the proposed study is to examine differences in microflora found on the nails of health care workers (HCWs) wearing artificial nails and the nails of HCWs with natural nails, assessing the effect on these microflora of hand cleansing with one of two preparations (i.e., antimicrobial soap or alcohol-based gel). The use of artificial acrylic fingernails has become popular over the last several years (Porteous, 2002). Artificial nails are known to harbor microbes and they cannot be cleaned as effectively as short, natural nails. Nevertheless, artificial nails are frequently worn by health care workers, even though the use of artificial nails is officially banned by organizations such as the Association of Operation Room Nurses (McNeil, Foster, Hedderwick, & Kauffman, 2001).
Hand washing remains the most effective and least expensive method to prevent the transmission of nosocomial infections (Wynd, Samstag, & Lapp, 1994). However, even after thorough hand cleansing, the fingernails in general, and the subungual region in particular, harbor a greater number of microorganisms than are found in other areas of the hand. This particular area is often neglected during routine hand washing (Wynd, et al, 1994). Alcohol formulations are widely used in Europe as an alternative to antimicrobial soap and are believed to have the advantage of saving time and providing potentially better germicidal activity when compared with soap-based hand cleansing (McNeil, et al, 2001).
The purpose of the proposed study, therefore, is to identify the relative efficacy of antimicrobial soap versus alcohol-based gel on the microbial colonization of artificial fingernails worn by HCWs. Several specific research questions are addressed in the study. These questions a...