Impact of a Single Plain Finger Ring on the Bacterial Load on the Hands of Healthcare Workers

Fagernes, Mette; Lingaas, Egil; Bjark, Per

doi:10.1086/520739

Cited by 28 publications

(25 citation statements)

References 26 publications

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“…2006, Waterman et al. 2006, Fagernes & Nord 2007, Fagernes et al. 2007, Wongworawat & Jones 2007, Al‐Allak et al.…”

Section: Discussionunclassified

“…The data were collected during two separate study periods in 2004 and 2007 (Fagernes et al. 2007, Fagernes & Lingaas 2009).…”

Section: The Studymentioning

confidence: 99%

“…Both hands were sampled with a modified version of the glove juice method. Each subject inserted their hand into a sterile bag (Stomacher ® 400 Classic; Seward, Worthing, UK) containing 100 ml of sterile tryptic soy broth with neutralizer as previously described (Fagernes et al. 2007, Fagernes & Lingaas 2009).…”

Section: The Studymentioning

confidence: 99%

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Factors interfering with the microflora on hands: a regression analysis of samples from 465 healthcare workers

Fagernes

Lingaas

2010

Journal of Advanced Nursing

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fagernes m. & lingaas e. (2011) Factors interfering with the microflora on hands: a regression analysis of samples from 465 healthcare workers. Journal of Advanced Nursing 67(2), 297–307. Abstract Aims. This paper is a report of a study of the impact of finger rings, wrist watches, nail polish, length of fingernails, hand lotion, gender and occupation on hand microbiology of healthcare workers. Background. The impact of the above mentioned variables on hand microbiology of healthcare workers is not well defined. Large scale studies suitable for multivariate analysis are needed to elucidate their role. Methods. Both hands of 465 Norwegian healthcare workers were sampled by the glove juice method during two study periods (2004 and 2007), and examined for total number of bacteria and presence of Staphylococcus aureus, Enterobacteriacea and non‐fermentative Gram‐negative rods. Multiple regression analysis was performed. Results. The use of a wrist watch was associated with an enhanced total bacterial count on hands compared to hands without a watch [(B) 3·25 (95% CI: 1·73–6·07), P < 0·001], while the use of one plain finger ring increased the carriage rate of Enterobacteriaceae [odds ratio 2·71 (95% CI: 1·42–5·20), P = 0·003]. The carriage rate of Staphylococcus aureus was enhanced with fingernails longer than 2 mm [odds ratio 2·17 (95% CI: 1·29–3·66), P = 0·004] and after recent use of hand lotion [odds ratio 22·52 (95% CI: 4·05–125·30), P < 0·001]. No effect of nail polish was observed. We found an association between occupation and carriage rate of S. aureus and Enterobacteriaceae. Conclusions. Health care workers should remove finger rings and watches at work. Fingernails should be shorter than 2 mm, nail polish may be used.

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“…2006, Waterman et al. 2006, Fagernes & Nord 2007, Fagernes et al. 2007, Wongworawat & Jones 2007, Al‐Allak et al.…”

Section: Discussionunclassified

“…The data were collected during two separate study periods in 2004 and 2007 (Fagernes et al. 2007, Fagernes & Lingaas 2009).…”

Section: The Studymentioning

confidence: 99%

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Factors interfering with the microflora on hands: a regression analysis of samples from 465 healthcare workers

Fagernes

Lingaas

2010

Journal of Advanced Nursing

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“…Fagernes et al (2007) found that total bacteria counts and Staphylococcus aureus were the same when ringed hands and non-ringed hands were compared, but wearing a single ring increased the total rate of Enterobacteria. Waterman et al (2006) found that removing rings is recommended before surgeons perform and prepare for procedures.…”

Section: Introductionmentioning

confidence: 91%

Simulated Microbe Removal around Finger Rings Using Different Hand Sanitation Methods

Alur¹,

Rane

Lorenz

et al. 2009

Int J Oral Sci

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Aim It is our opinion that the CDC and the WHO have underestimated cross-contamination under examination gloves in dental clinics while wearing jewelry, such as finger rings. These agencies only "recommend" removing jewelry, and only washing hands for 15 seconds with soap and warm water before donning gloves. This study examined several washing procedures and finger rings using simulated microbes. Methodology A gloved rubber hand manikin was made and fitted with a fresh disposable vinyl glove. Four fingers were fitted with rings or no ring, dusted with simulated microbes, and washed with a scrub brush for 5, 15, and 25 seconds under 20°C and 40°C water alone, or with liquid hand soap. Light levels (in lux) of fluorescent powder before and after washing were measured and delta scores calculated for changes in light levels, equivalent to effectiveness of hand washing procedures.A full-factorial, 3-factor analysis of variance (ANOVA) was used to test for differences among levels of the three study factors-time, temperature, and soap use. Tukey's post hoc honestly significant difference (HSD) test was applied to significant factors to examine pair-wise differences between factor levels. Results It was found that the longer the hands with rings were washed with a scrub brush under flowing water, the more simulated microbes were removed. By 25 seconds, all methods were essentially the same. Simulated microbes were more difficult to remove from the palm compared to the back of the hand. The liquid hand soap used in this study was more effective with warm water than cold. When given a choice of washing with cold water up to 15 seconds, it would be preferable not to use soap to remove simulated microbes. Qualitatively, the outer surface of finger rings were more effectively cleaned than the crevice below the ring, and the ring with a stone setting appeared to accumulate and retain simulated microbes more than other rings. Conclusion The most effective treatment was washing with warm water and liquid soap. Longer times were more effective. Rings should not be worn under examination gloves due to difficulty cleaning in the crevice under the ring, and the well-known consequences of cross-contamination between the patient and the health care worker.

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“…Remove rings, wrist-watch, and bracelets before beginning surgical hand preparation (II). 962,965,966,968,1016 Artificial nails are prohibited (IB). 154,167,534,974,977 B. Sinks should be designed to reduce the risk of splashes (II).…”

Section: Recommendations For Surgical Hand Preparationmentioning

confidence: 99%

Hand Hygiene

Longtin¹,

Sax²,

Allegranzi³

et al. 2011

N Engl J Med

108

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Impact of a Single Plain Finger Ring on the Bacterial Load on the Hands of Healthcare Workers

Cited by 28 publications

References 26 publications

Factors interfering with the microflora on hands: a regression analysis of samples from 465 healthcare workers

Factors interfering with the microflora on hands: a regression analysis of samples from 465 healthcare workers

Simulated Microbe Removal around Finger Rings Using Different Hand Sanitation Methods

Hand Hygiene

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