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Student nurses complain qualified colleagues wear nail varnish

Qualified staff often set a poor example to nursing students on infection prevention and control practices, claim the authors of a study.

They found 100% of the student nurses they surveyed had observed lapses in infection prevention and control practices during their clinical placements.

The researchers, from Cardiff University and London’s City University, conducted an anonymous online survey of nursing students who were members of the Royal College of Nursing.

All of the 488 students who completed the 19-question survey reported witnessing at least one instance of non-compliance with infection prevention and control procedures. The most frequently observed events related to hand hygiene.

More than 75% of respondents saw healthcare workers fail to clean hands between patients, and 60% saw healthcare workers wearing nail polish or nail extensions.

Other lapses observed by more than half of survey respondents included failure to comply with isolation precautions, inadequate cleaning of the patient environment, not changing personal protective clothing between patients, and poor handling of sharp instruments.

The students commented most often about the poor hygiene and safety habits of doctors, but all occupational groups were criticised for touching their face, biting nails, and scratching during patient care.

The authors said: “Qualified staff provided poor role models for student nurses. The findings of this study indicate the need for better role models for student nurses.”

The study was published in the latest issue of the American Journal of Infection Control.

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Readers' comments (18)

  • It would be interesting to see how many of these students would themselves be guilty of 'lapses' when they qualify and join the ranks of those who appear to be guilty of the most heinous crimes in healthcare.........The Registered Nurse. Off with their heads, I say. Oh dear, what would happen to all those sick people? Who would after them.

    It would be nice to, just once, have an article which shows the evidence base for the frankly superb job that the vast majority of qualified nurses in spite of all the obstacles and sh*t thrown at them.

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  • I suspect that we are all guilty of occasional dipps and may do something silly like not boiling our hands regularly enough...

    That said the vast majority of care will be done at least adequately, and mistakes will happen.

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  • Once again another survey designed to degrade what nurses do. How about letting us have lives outside of work? In every other occupation it is acceptable, why not nursing? I understand the reasons behind nail polish and nail extension removal, but touching our faces and scratching??? I think the general public sometimes forget that we are indeed human, and have human needs....such as scratching an itch!

    How about an article about nurses having to look after 8 sick patients a shift, answering bells from people demanding their water jugs be refilled, having so many isolated patients that most of the shift is actually taken up by putting on and removing isolation gowns, gloves, face masks etc?

    Most nurses I have worked with are 100% dedicated to patient care, but find it a struggle dealing with the huge amount of paperwork (a lot of which is doubled up from one ward to another). When am I going to have the privilege to read an article about how great nurses are, the care they give in extremely challenging situations, and what a huge benefit they are to the community, for the low wages they receive, and the long hours they put in?

    I am sick of seeing the work that healthcare professionals do put down and torn apart. We are only there to help and support the public. We don't need to keep being run down by those in the media.

    Sorry about the rant.

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  • Low wages and long hours?

    Can you earn as much in the same span elsewhere?
    This is a bit of a throwback to the 70s and 80s.
    We earn the average wage on the whole [which means many are paid less] and even with a bit of unpaid OT do not really work long hours generally. A long day is of course long hours - but only 13 shifts per 28 days.
    Back in the 70s we were truly downtrodden... and I feel pretty well off in comparison. But I never came into nursing for the money - I am one of those sad saps who had a 'vocation'

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  • Anonymous | 10-Sep-2013 12:45 pm

    No. You are just one of those sad saps who dragged this profession down into the gutter because you didn't have the intelligence to see how badly you were treated and how poorly you were remunerated. Or the courage to do anything about it. Your legacy is a downtrodden, low status, low paid and, (worst of all), low aspiration 'profession'. And you have the cheek to call that a 'vocation'.

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  • Anonymous | 10-Sep-2013 12:21 pm

    Well said.

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  • Anonymous | 10-Sep-2013 1:28 pm

    at least in those days you could call it 'nursing'!

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  • Anonymous | 10-Sep-2013 2:39 pm

    You also scrubbed the floors with a toothbrush, ran around making tea for matron and the doctors and spent hours emptying the ashtrays on the patients lockers! In those days you harmed and killed more people with antiquated and dangerous practices. Take off the rose tinted spectacles and blink in the harsh light of truth.

    FYI.......it is still called Nursing.

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  • Anonymous | 10-Sep-2013 4:26 pm

    it might still be called nursing in name only as there are no better alternatives.

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  • Anonymous | 10-Sep-2013 5:05 pm

    That's your best shot?! You really have no idea, have you?

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  • George Kuchanny

    Anonymous | 10-Sep-2013 4:26 pm

    Something I have noticed these days is that very often a nurse (or doctor) will give an injection without swabbing a small area of skin beforehand with a swab. To me this appears to be a very dangerous corner to cut if the patient has had a lot of medication that has a known side effect of reducing white blood cell count aka the T and B cells. My view is that skin should be swabbed every time an injection is given. What do you think?

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  • George Kuchanny | 11-Sep-2013 0:20 am

    have a look at more recent evidence based studies. swabbing is not always indicated.

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  • tinkerbell

    Research over the last 30 years has questioned the value of skin preparation prior to injections. A landmark study by Dann was carried out at a university medical centre where more than 5,000 injections were given without skin preparation to patients between four and 66 years of age.

    No cases of infection, either local or systemic, were identified. As a result of this study it was suggested that routine skin preparation was unnecessary and questioned the assumption that infection could be introduced via the needle from unsterilised skin.

    A study on 13 people who have diabetes, found that although a five second skin preparation with alcohol swabs prior to injection reduced skin bacterial counts by over 82%, such disinfection is not necessary to prevent infection at the injection site.

    When 1,700 injections were given without an alcohol swab no infection occurred. Other studies concur with these findings and suggest that generally there was insufficient contaminating of skin to cause infection following injection without disinfection and that skin cleansing was an unnecessary procedure.

    Further research has reinforced the importance of ensuring that the skin of the patient is physically clean and that healthcare providers maintain high standards of hand hygiene prior to the procedure.

    Scientific evidence to support the use of soap and water for skin cleansing is limited, however it has been suggested that the physical action of washing has long been accepted for the removal of transient flora which may contaminate the skin.

    Another study carried out a review of best practice in relation to the prevention of injection associated infection for the World Health Organisation (WHO). In association with their Safe Injection Global Network, The WHO no longer recommend swabbing clean skin with a disinfectant before giving intradermal, subcutaneous, and intramuscular needle injections

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  • What is the purpose of a study like this? Or journalism like this? We all know nursing is a demanding job, so why pile on the crap with totally irrelevant"studies" like this which are, frankly, just tomorrows fish n chip wrappers?

    Never mind the government agenda - let's see some encouragement for nursing.

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  • David Baird | 11-Sep-2013 10:49 pm

    every little detail seems to now merit endless surveys, studies and investigations without any signs of visible change once the results have been published. it seems they are just to give somebody a job or fill up the shelves of archives!

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  • George Kuchanny


    tinkerbell | 11-Sep-2013 2:20 pm

    Thanks Tinkerbell, question fully answered. I had thought that it might be tied up with the undoubted fact that we are all a bit more fond of washing these days as opposed to the days of tenement blocks and metal bath tubs :). Stabbed myself many times, worst was a barbed hook straight through my thumb, missing the bone and coming out above the nail. Eased it out myself instead of doing the A&E thing. No infection at all despite being advised to have an "anti-weird germs that live in earth" injection.

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  • George Kuchanny

    Final thought I had about my question was that swabbing was the rule when needles were multi-use. No longer a problem now that they have just about all been ditched in favour of single use sharps. In fact I have not seen an old multi-use glass and chrome job with screw on needle for at least ten years now. Good riddance. Same for glass & mercury thermometers. Nice Braun ear job does core temp most accurately. Heavens knows what orifice the old ones were plummeted into on the last patient before being used on the next one. Ewww!

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  • tinkerbell

    George, just catching up as been away to my retreat in the mountains.

    I take a bath a least once a year, even if I don't need one:)

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