Studies have demonstrated that skin underneath rings is more heavily colonized than comparable areas of skin on fingers without rings. However, rings and decorative nail jewelry can make donning gloves more difficult and cause gloves to tear more readily. Thus, jewelry should not interfere with glove use (eg, impair ability to wear the correct-sized glove or alter glove integrity).
Recommendations
1. General Considerations
a. Perform hand hygiene with either a non-antimicrobial or antimicrobial soap and water when hands are visibly dirty or contaminated with blood or other potentially infectious material. If hands are not visibly soiled, an alcohol-based rub can also be used. Follow the manufacturer's instructions.
b. Indications for hand hygiene include:
i. When hands are visibly soiled.
ii. After barehanded touching of inanimate objects likely to be contaminated by blood, saliva or respiratory secretions.
iii. Before and after treating each patient.
iv Before donning gloves.
v. immediately after removing gloves.
c. For oral surgical procedures, perform surgical hand antisepsis before donning sterile surgeon's gloves. Follow the manufacturer's instructions by using either an antimicrobial soap and water, or soap and water followed by drying of hands and application of an alcohol-based surgical handscrub product with persistent activity.
d. Store liquid hand-care products in either disposable closed containers or closed containers that can be washed and dried before refilling. Do not add soap or lotion to (ie, top off) a partialy empty dispenser.
2. Special Considerations for Hand Hygiene and Glove Use
a. Use hand lotions to prevent skin dryness associated with handwashing.
b. Consider the compatibility of lotion and antiseptic products and the effect of petroleum or other oil emollients on the integrity of gloves during procedures.
c. Keep fingernails short with smooth, filed edges to allow thorough cleaning and prevent glove tears.
d. Do not wear artificial fingernails or extenders when having direct contact with patients at high risk (eg, those in intensive care units or operating rooms).
e. Use of artificial fingernails is usually not recommended.
f. Do not wear hand or nail jewelry if it makes donning gloves more difficult or compromises the fit and the integrity of the glove.