[Impact of the use of rings and nail polish on hand hygiene quality in healthcare workers]. / Impacto del uso de anillos y uñas esmaltadas en la calidad de la higiene de manos en el personal de salud.

BACKGROUND: Health-care-associated infections are a frequent problem in hospital environments. Hand hygiene is the most effective measure to prevent outbreaks. The use of certain accessories could decrease its effectiveness, facilitating horizontal transmission of pathogens. OBJECTIVE: Analyze the evidence that assess the impact of the use of rings and nail polish on hand hygiene quality in healthcare workers. METHODS: Non-systematic search in PUBMED/MEDLINE database (1978-2018) of studies in which the quality of hand hygiene or surgical washing is measured, using quantitative cultures or fluorescent stains. RESULTS: Wearing rings: 13 studies met the inclusion criteria. Seven were carried out in general wards. In all of them the use of rings was associated with lower quality of hand hygiene (the majority of low quality). Contrarily, in 3 of 4 primary studies carried out in the operating rooms (of low quality), their use did not affect the quality of surgical washing. Similarly, two systematic reviews obtained similar conclusions. Nail polish: 7 of 54 studies met the inclusion criteria. In four of them there were discordant results (the majority of low quality). One RCT showed a reduction in the quality of surgical washing only when the nail polish was damaged. Gel nail polish was associated with lower quality in two experimental studies. CONCLUSIONS: There is insufficient evidence to associate the use of these accessories with the reduction in the quality of hand hygiene. Its safety was not proven neither. Based on the available evidence (the majority of low quality), a negative impact of the use of rings in clinical units and also of damaged nail polish in operating rooms was observed. Better quality studies are required to address these relevant issues.

Impacto del uso de anillos y uñas esmaltadas en la calidad de la higiene de manos en el personal de salud / Impact of the use of rings and nail polish on hand hygiene quality in healthcare workers

Resumen Introducción: Las infecciones asociadas a la atención de salud son un problema frecuente en el ambiente hospitalario. La higiene de manos es la medida más efectiva para su prevención. El uso de ciertos accesorios en las manos podría disminuir su efectividad y favorecer la transmisión horizontal de agentes infecciosos. Objetivo: Revisar los estudios publicados que evalúan el impacto del uso de anillos y uñas esmaltadas en la calidad de la higiene de manos en trabajadores de la salud. Métodos: Búsqueda no sistemática en base de datos PUBMED/MEDLINE (1978-2018) de estudios en los cuales se mide la calidad de la higiene de manos o lavado quirúrgico, mediante cultivos cuantitativos o tinciones fluorescentes. Resultados: Uso de anillos: Trece de 51 artículos cumplían los criterios de inclusión. Siete fueron realizados en unidades clínicas, y en todos ellos éste se asoció a menor calidad de la higiene de manos (la mayoría de baja calidad). Contrariamente, en tres de cuatro estudios primarios realizados en pabellón (de baja calidad), su uso no impactó en la calidad del lavado quirúrgico. Igualmente, dos revisiones sistemáticas obtuvieron similares conclusiones. Uñas esmaltadas: siete de 54 artículos fueron incluidos. En cuatro hubo resultados discordantes (la mayoría de baja calidad). En un estudio controlado se observó reducción en la calidad del lavado quirúrgico sólo cuando el esmalte estaba dañado. El esmalte gel se asoció a menor calidad de la higiene de manos en dos estudios experimentales. Conclusiones: No existe evidencia de calidad suficiente para asociar el uso de estos accesorios con reducción en la calidad de la higiene de manos. Tampoco queda demostrada su inocuidad. En base a la evidencia disponible (la mayoría de baja calidad), se observó un impacto negativo del uso de anillos en unidades clínicas y también de uñas con esmalte dañado en pabellones quirúrgicos. Se requieren estudios de mejor calidad para abordar estos relevantes tópicos.

Abstract Background: Health-care-associated infections are a frequent problem in hospital environments. Hand hygiene is the most effective measure to prevent outbreaks. The use of certain accessories could decrease its effectiveness, facilitating horizontal transmission of pathogens. Objective: Analyze the evidence that assess the impact of the use of rings and nail polish on hand hygiene quality in healthcare workers. Methods: Non-systematic search in PUBMED/MEDLINE database (1978-2018) of studies in which the quality of hand hygiene or surgical washing is measured, using quantitative cultures or fluorescent stains. Results: Wearing rings: 13 studies met the inclusion criteria. Seven were carried out in general wards. In all of them the use of rings was associated with lower quality of hand hygiene (the majority of low quality). Contrarily, in 3 of 4 primary studies carried out in the operating rooms (of low quality), their use did not affect the quality of surgical washing. Similarly, two systematic reviews obtained similar conclusions. Nail polish: 7 of 54 studies met the inclusion criteria. In four of them there were discordant results (the majority of low quality). One RCT showed a reduction in the quality of surgical washing only when the nail polish was damaged. Gel nail polish was associated with lower quality in two experimental studies. Conclusions: There is insufficient evidence to associate the use of these accessories with the reduction in the quality of hand hygiene. Its safety was not proven neither. Based on the available evidence (the majority of low quality), a negative impact of the use of rings in clinical units and also of damaged nail polish in operating rooms was observed. Better quality studies are required to address these relevant issues.

Prevalencia y factores sociodemográficos que condicionan el uso de joyas (y la percepción del riesgo de accidentes que conlleva) en niños menores de dos años / Sociodemographic prevalence and factors that condition the use of jewellery (and the perceived risk of accidents involved in children less than two years old)

Objetivos: conocer la prevalencia del uso de joyas (y la percepción del riesgo que conlleva) en niños menores de dos años de edad y establecer los factores sociodemográficos y culturales que lo determinan. Material y métodos: se diseñó un estudio observacional descriptivo transversal. Se realizó un cuestionario a padres en las consultas de Pediatría de cuatro áreas asistenciales durante seis meses. Las variables de caracterización referidas a los lactantes fueron: edad, sexo, número de hermanos, orden y convivientes. Las referidas a los padres: edad, sexo, nivel de estudios, profesión, país de origen, lugar de residencia y religión. Y las referidas a las joyas: tipo, material, procedencia, uso, tiempo, motivos y situaciones de uso. Así mismo, se preguntó sobre la percepción del riesgo de accidentes asociado. Resultados: se contabilizaron 319 cuestionarios. Las personas que regalaron joyas a los lactantes fueron con mayor frecuencia los familiares en primer grado (74,1%). Entre los riesgos de lesión potencial atribuidas a su uso, destacaron el estrangulamiento por cadenas (63,7%) y el atragantamiento por anillos (19,9%). El 40% de los hijos cuyos padres conocían algún caso de accidente por joyas usaba al menos una. Tenían más joyas los niños de mayor edad, aunque predominaba su uso en los menores de seis meses. Los padres de los niños más pequeños y de los mayores, dentro del rango de edad estudiado, eran los que percibían mayor riesgo en el uso de las joyas. Conclusiones: el uso de joyas entre los lactantes fue muy frecuente. Sus familias no mostraron una clara percepción de riesgo respecto a este hábito y tampoco habían recibido la información suficiente como para evitarlo (AU)

Objectives: to determine the prevalence of jewels use (and the perception of risk involved) in children under two years old and establish the sociodemographic and cultural factors that determine it. Materials and methods: we designed an observational descriptive transversal study. We conducted a questionnaire to parents in the pediatric outpatient clinics of 4 health areas during six months. The descriptive variables concerning infants were age, sex, number of siblings, order and cohabitants. Parents’ variables were age, sex, educational level, occupation, country of origin, place of residence and religion. Relating to jewels: type, material, origin, use, time, subject and situation of use. We also asked about the associated risk of accidents perceived. Results: there were 319 questionnaires. People that gave jewels to infants were more often first-degree relatives (74.1%). The risks of potential injury attributed to its use emphasized strangulation by chains (63.7%) and choking by rings (19.9%). Forty percent of children, whose parents knew cases of jewels’ accidents, used at least one. The older children had more jewels, although its use in the minors of 6 months predominated. The parents of the smallest and eldest children, within the studied rank of age, were those that perceived a major risk in the use of jewels. Conclusions: jewel use among infants was very frequent. Their families did not show a clear perception of risk respecting to this habit and they had not either received the sufficient information to avoid it (AU)

Alfons Serrahima orfebre y joyero del deporte / Alfons Serrahima goldsmith and jeweller of sport

No disponible

[Assessing the wearing of jewellery by French healthcare professionals]. / Évaluation du port de bijou chez des professionnels de la santé français.

OBJECTIVE: A prospective observation study was undertaken in seven medical centers, in the French region Alpes-Maritime, to assess nail hygiene of healthcare professionals and how often they wear hand jewellery. METHOD: Seven hundred and six healthcare workers in seven medical centers were interviewed from March to April 2008. RESULTS: Among the 706 professionals, 306 (43%) were wearing one or several pieces of jewellery. The nails of 81 (11.5%) were non-standard according to guidelines. Three hundred and forty-four health care professionals (49%) were wearing one or several pieces of jewellery and/or presented with non-standard nails. In univariate analysis, the wearing of jewellery was linked to the medical centre (P<0.001), to the professional category (p<0.001), to the number of times people washed their hands or used hand gel per day (ABHR) by categories (<10 times per day or ≥10 times per day) (P<0.017). In the multivariate analysis, the risk factors linked to the wearing of jewellery were the medical centers, the professional category, and the age. CONCLUSION: There are still too many healthcare professionals who do not comply to French recommendations on hand hygiene concerning the wearing of jewellery and nail hygiene standards.