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?

Any examples are for illustrative purposes only.

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.