The Case of Artificial Nails

The Case of Artificial Nails

Katira Marshall, Toyin Ajayi, Sharun Manu

West Chester University

Applied Nursing Research NSG313-90

Professor Megan A. Infanti Mraz RN, PhD

13 July, 2022


Maintaining proper hand hygiene among clinical workers is important to reduce the prevalence of the disease. However, there are several techniques are used to promote hand hygiene. This paper is going to focus on the use of liquid soap to clean the hand and nails.


In clinical care practice use and maintenance of proper hand, hygiene is very important. This is because, in most cases, the hand contains a high level of microorganisms, which can lead to disease. However, in most cases, nurses do not give enough attention to this topic. As a result, poor hand hygiene practice in a nursing facility leads to additional disease risk for the patient. Moreover, poor hand hygiene is also harmful to nurses (Ellingson et al., 2014). Lin et al., (2003) mention in most cases, clinical setting follows poor hand hygiene protocol, and they provide less funding to improve the hand hygiene practice in a care facility. As a result, this can lead to the development of several pathogenic diseases. For instance, E.coli is a very common bacterium, which can be found within nails. Hence, poor hand hygiene practices e can lead to E.coli-related infection.

As a result, from a nursing standpoint, poor hand hygiene can be considered a significant issue. Moreover, nowadays many female nurses use artificial nails for beauty purposes. However, due to their long size, artificial nails can contain more pathogenic microorganisms compared to normal nails. Hence, it is important to properly clean hands and nails (Ellingson et al., 2014). There are several techniques are used to properly clean hands. However, this paper is going to particularly focus on liquid soap.

Hence, here the PICO question is about the use of liquid soap to reduce the microbial load in hand and artificial nails compared to alcohol use and other hand washing technique.

Search strategy

For this research, PubMed was used. Here, the keywords along with Boolean operators like OR and AND were used to find the proper papers. The keywords for this search were keywords 1: Hand hygiene and Keyword 2: Artificial Fingernails and Keyword 3: Health care workers were used. The inclusion criteria for this paper include being published within 20 years, discussing hand hygiene techniques and the presence of microorganisms within the fingernails of healthcare workers, and the paper that is written in the English language. Exclusion criteria for this search include articles that are not written in English, articles that are not relevant to the topic, and articles which are not peer-reviewed.

Literature review

Lin et al., (2003) investigated the impact of different hand washing techniques to remove caliciviruses and E.coli. In this research, the author considered both artificial and normal fingernails. In this study, they made a bacterial preparation containing E.coli, which was then mixed with the grounded beef and put into the gloves. Human volunteers were selected to perform the research. In this study, a total of 6 hand washing methods were checked, which were liquid soap with a nailbrush, alcohol gel, alcohol-based sanitizer, antibacterial liquid soaps, regular liquid soaps, and tap water cleaning. According to the findings, the author mentioned the use of liquid soap with a nailbrush had the greatest result. However, the alcohol-based solution did not provide a good result. Moreover, this study indicates that the use of soap is effective to reduce the load of microorganisms in both artificial and normal nails regardless of their sizes. Therefore, this study demonstrates that the use of soap is more effective compared to alcohol-based solutions.

Likewise, McNeil et al., (2001) conducted a similar study on 21 healthcare workers (HCW) to check the efficacy of antimicrobial soaps against alcohol-based gel. However, in this study, only artificial nails were used. Also, this study has a control group of 20 HCWs to compare the effectiveness. In this study, the cultures were obtained from all of the participants and it was analyzed and contrasted to get the result. According to the findings, McNeil et al., (2001) mention, that the experimental group has 86% of microorganisms in their hand before the experiment. However, after the intervention, the load of pathogens decreased in both cases.

According to this evidence, both alcohol and soap can be effective enough to reduce the level of microbes in length. This can reduce the load of germs in both normal nails and in artificial nails. Hence, in a clinical setting use of liquid soap with a nailbrush needs to be focused on to improve hand hygiene.


Implementation of proper hand hygiene in the workplace is important to reduce the prevalence of the disease. Hence, to promote good hand hygiene practice use of liquid soap with a nailbrush is important.


Ellingson, K., Haas, J., Aiello, A., Kusek, L., Maragakis, L., Olmsted, R. & Yokoe, D. (2014). Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene. Infection Control & Hospital Epidemiology, 35(S2), S155-S178. doi:10.1017/S0899823X00193900

Lin, C. M., Wu, F. M., Kim, H. K., Doyle, M. P., Michaels, B. S., & Williams, L. K. (2003). A comparison of hand washing techniques to remove Escherichia coli and caliciviruses under natural or artificial fingernails. Journal of Food Protection, 66(12), 2296-2301.

McNeil, S. A., Foster, C. L., Hedderwick, S. A., & Kauffman, C. A. (2001). Effect of hand cleansing with antimicrobial soap or alcohol-based gel on microbial colonization of artificial fingernails worn by health care workers. Clinical Infectious Diseases, 32(3), 367-372.

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