Outbreaks of nosocomial infections (particularly Gram negative rods) have been associated with long artificial fingernails worn by NICU staff.

VUMC NICU staff should refrain from wearing artificial fingernails. Staff should maintain a reasonable length of their natural fingernails. Nail polish can be worn. Good hand washing is a must. Scrub brushes with nail picks should be used at the beginning of each shift.

Discussed at Nursery Policy & Procedure Meetings 5/17/00 and 10/18/00.

References:

Hedderwick et al. Pathogenic organisms associated with artificial fingernails worn by healthcare workers. Infection Control & Hospital Epidemiology 21(8):505-9, 2000.

Foca et al. Endemic Pseudomonas aeruginosa infection in a neonatal intensive care unit. NEJM 343(10):697-700, 2000.

Moolenaar et al. A prolonged outbreak of Pseudomonas aeruginosa in a neonatal intensive care unit: did staff fingernails play a role in disease transmission? Infection Control & Hospital Epidemiology 21(2):80-5, 2000.

Passaro et al. Postoperative Serratia marcescens wound infections traced to an out-of-hospital source. Journal of Infectious Diseases 175(4):992-5, 1997.