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The Centers for Disease Control and Prevention’s draft Guideline for Hand Hygiene in Healthcare Settings recommends the following regarding surgical scrub brushes and fingernails.1 The ranking of each recommendation is included.
Surgical hand antisepsis
• Surgical hand antisepsis, using either an alcohol-based hand rub or an antimicrobial soap, is recommended before donning sterile gloves when performing surgical procedures. Category IB. Strongly recommended for implementation and supported by some experimental, clinical, or epidemiologic studies and a strong theoretical rationale.
• To reduce the number of bacteria that may be released from the hands of surgical personnel, while minimizing skin damage related to surgical hand antisepsis, decontaminate hands without using a brush. (IB)
Nails and rings
• Do not wear artificial fingernails or extenders when providing patient care. Category IA. Strongly recommended for implementation and strongly supported by well-designed experimental, clinical, or epidemiologic studies.
• Keep natural nails less than ¼ inch long. (II) Category II. Suggested for implementation and supported by suggestive clinical or epidemiologic studies or a theoretical rationale.
• Wearing rings in health care settings. No recommendation. Unresolved issue: Practices for which insufficient evidence or no consensus regarding efficacy exist.
1. Centers for Disease Control and Prevention, the CDC Healthcare Infection Control Practices Advisory Committee, Boyce JM, Pittet D, the HICPAC/SHEA/ APIC/IDSA Hand Hygiene Task Force. Draft Guidelines for Hand Hygiene in Heathcare Settings. Atlanta; 2001.