The caregiver who assists my 96-year-old mother wears long artificial fingernails. Is that safe?

The AORN has the following recommendations about fingernails:
Fingernails should be kept short, clean, and healthy.

A single-use nail cleaner should be used under running water to clean the debris from the subungual area, which harbors the most organisms found on the hands.

Long fingernails may pose a hazard to patient safety when moving or positioning the patient.

Long fingernails require extra effort when cleaning subungual areas.

When fingernails are long, gloves may tear, presenting a risk to both the nurse and the patient.
The AORN has the following recommendations about fingernail polish:
If used, nail polish should not be chipped.

Studies have demonstrated that chipped nail polish may support the growth of organisms on the fingernails.

While no studies have demonstrated a relationship between freshly applied nail polish and infection,[1] there is concern that individuals with fresh manicures may be hesitant to perform rigorous hand hygiene in an effort to protect their nails. Compromises in hand hygiene technique may then lead to transmission of infection.

If nail polish is worn, it should not be worn for more than 4 days. At the end of 4 days, nail polish should be removed and freshly reapplied.

Individuals who choose to wear nail polish should be guided by their surgical conscience, which requires a combination of clinical experience, judgment, critical thinking, and the ability to question a practice when one believes it is not the right thing to do.
The AORN recommends the following concerning acrylic (artificial) nails:
Artificial nails should NOT be worn.

Numerous studies validate the increased number of bacteria cultured from the fingertips of persons wearing artificial nails, both before and after hand washing.

State Boards of Cosmetology report that fungal growth occurs more frequently under artificial nails.
The Bottom Line
Even the World Health Organization guidelines on hand hygiene state that wearing artificial acrylic nails can contribute to hands remaining contaminated with pathogens after use of soap or alcohol-based hand gels.[8] Considering all of these recommendations and cautions about long fingernails, nail polish, and acrylic nails, the answer to your question regarding a colleague who still wears artificial nails might be summed up by suggesting that nurses refrain from such a practice in the interest of preventing healthcare-associated infection. All nurses, not just those who care for perioperative patients or others at high risk for infection, should be guided by their conscience and the research data that suggest that both artificial nails and even nail polish can put patients at risk.

This question is from April of this year. I wonder what happened and if the long finger nailed caregiver is still working. To me, a person attempting to provide hands on care to a senior who has long artificial or real nails either is ignorant of the risks and recommendations by professionals or they don't care and the patient's health is not a priority to them. It would speak volumes to me about her as a professional, regardless of what you may believe otherwise.

http://m.nailsmag.com/article/81754/nurses-and-nails

National Patient Safety Goals (NPSG) (Critical Access Hospitals / Critical Access Hospitals)
CDC or WHO - Artificial Nails and Gels
The CDC guidelines say that health care personnel should not wear artificial nails and should keep natural nails less than one quarter inch long if they care for patients at high risk of acquiring infections (e.g. patients in intensive care units or in transplant units). The WHO guidelines prohibit artificial nails and extenders for all healthcare workers. Will Joint Commission actually be requiring this?
Each organization must follow the IA, IB and IC recommendations from the guideline it chooses (CDC or WHO). Therefore, if WHO is chosen, no direct care providers should have artificial nails or extenders. If CDC is chosen, providers in high-risk areas must not wear artificial nails.
Many organizations following CDC guidelines have chosen to expand the ban on artificial nails, nail gels, gel colors, etc., to all care providers in the interest of safety. Regarding the length of natural nails, each organization may choose its own approach since the level of recommendation in both the CDC and WHO guidelines is "II", thereby making compliance optional.
In addition to the CDC and WHO, organization's requirements should incorporate evidence-based guidelines for specialized and/or procedural areas. AORN, AAMI and APIC are additional examples of resources for such guidelines.

What about wearing gloves, you ask? The CDC advises that wearing gloves can reduce pathogens but “does not offer complete protection against hand contamination.” It becomes increasingly clear that the aim of the CDC guidelines for healthcare are three-fold — wash well, glove-up, and reduce the places bacteria have to hide. Stop playing hide-and-seek with pathogens by scheduling manicures and frequent polish changes for nurses or other health care workers. Put together a retail package including: light colored polish, polish remover, cuticle oil, and a file or natural nail buffer. Encourage clients involved in patient care to change polish every four days (a CDC recommendation) or when it becomes chipped. Chipped polish may up the risk of contamination.

While enhancements and long nails still seem to be a no-no, nurses can and should enjoy the healthy benefits of well-maintained natural nails.

I have asked people not to have artificial nails around my grandma. I have found scratches on her multiple times with fake nails and she has dementia so my philosophy is, I keep her nails short enough so she don't cut the caregiver (not from lack her trying mind you), I would ask them to keep their nails clean and short to not cut her.

Well... as someone who often wears a wide variety of no-chip manicures, or store bought artificial glue-on nails if I have a special event and need to get nails done in a pinch, and also used to get acrylic nails added over my own for my froufrou sales job 10 years ago because they would stay "done" for weeks at a time that way...

Could we stay on the topic of how these nails affect caregivers and not give meaningless personal opinions about what kind of women wear artificial nails, or what you personally think about them.  It's not the point and it's going to offend someone.  I'm sure I can't be the only regular poster on AC who has worn or wears nails for myriad reasons and no one needs the baseless judgment.  

Nasty! Fake nails are tacky and dirty. I don't like to see them on anyone who is touching anything important to me.

Why not let her know how good a job she is doing and gently tell her your concerns about the fingernails possibly hurting your mother because of her delicate skin. This way, she will less likely be offended and instead of wanting to leave for being reported, may want to stay and be more cooperative with you and Mom.

Hubby had a liver transplant 12 years ago--I happened to be wearing longer (still pretty short) acrylic nails, as we had just had a wedding in the family, and I was keeping up the "look"--Hubby's dr took my hand one night at the hospital and said "I know what you're going to be doing tonight...these have GOT TO GO". Ugh. Painful to remove and ugly, thins nails underneath....but absolutely, harbingers of bacteria we did not want around him.

Now, out of habit, I keep my nails so short they couldn't scratch anyone.

Also, when I worked Elder Care, we could not have long fake nails either. It was as much to protect US as our clients.

I could have sworn people of all races wear long fingernails from salons. When I walk by at Walmart I see all levels of socioeconomics too.

Short nails are essential for infection control. When mom gets C-Diff and worker takes it home to her baby, she is not going to be happy at all!

I don't comprehend the level of conjecture it would take to mention race here. That's an unfortunate comment. It bothers me, too, Daughter.

Anyway. There are many studies done about this very thing, how that wearing artificial nails in healthcare environment has directly contributed to more contamination, more infections. Google those and read a few, if you want to have a better understanding of how to approach the topic from a scientific standpoint and you can approach this in a way to enlist the willing compliance of the caregiver. They sound like they want to take good care of your mom and they must not be aware of the potential for problems with the nails.

I’ve come back to the above twice now, it really bothers me. The OP didn’t mention race and it’s really inappropriate. Both families in need of care and caregivers come in all races as do people who choose to wear long, acrylic fingernails. The issue is the nails, not race. There are many of my race, certainly of all our races, that each of us wouldn’t want to be lumped into a category with. Let’s not do it here.

If you complain the aid will quit. The woman is doing a good job you say? The next aid might not.

Unprofessional, unacceptable. Clean hands are the basis of infection control and long nails on ungloved hands are out. Address this either directly, yourself, or indirectly through her agency.

I’m a nurse & per my employer policy could not have long nails. Bacteria can grow underneath them which can be transferred from patient to patient.
I see those long fingernails on many caregivers and wonder how the heck they can work with them. Even when using gloves the long nail will cause the glove to tear.
Unfortunately the policy of short finger nails is overlooked more often than not these days.
You can call the agency to report it, then the employee may quit and the employer will be short staffed, so many employers do nothing.
I myself am a handwashing freak but I know the dangers of not following infection control.
I agree 100% long fingernails are an issue when delivering patient care & can’t understand how the employee can perform their job with them (same with computers) but I don’t know the solution.

Unless she uses bacterial soap and a scrub brush when washing her hands, no, artificial nails and even long natural are a no no if ur in the medical field.

I'd be more concerned about the aide not using the gloves than with her long nails.

I used to wear acrylic nails because my own nails were so thin and ugly. I never had a problem scratching myself or tearing delicate skin. And I worked in health care. If I was giving a bath to a patient the washcloth would be between my gloved hand and the patient's skin. Same with toileting. The tissue paper would be between my gloved hand and the delicate skin. Your caregiver's hands should not be coming in contact with your mom's skin during bathing or toileting but not because of her nails but because of hygiene purposes. The caregiver should be gloved any time she has contact with your mom during bathing and toileting.

Ugh, I wouldn’t like this a bit! My mom had all the type care you describe and no caregiver had long nails, I doubt it was allowed. I’d have to speak up

As a former CNA, we were not allowed to have long nails or artificial nails. Long nails because of the obvious, scratching people and no artificial nails as bacteria can grow when nail polish starts to chip and again scratching someone. If she is from an agency I would call to voice your concerns if in a facility I would talk to Nurse or DON.