On February 1, 2003.

Personnel affected include, but are not limited to nurses, physicians, respiratory therapists, phlebotomists, PCAs, PSAs, and anyone who has direct patient contact or staff who handle patient care products.

Employees have a responsibility for maintaining hand hygiene by adhering to specific infection control practices. Artificial fingernail enhancements contribute to nail changes that can increase the risk of colonization and transmission of pathogens to patients. Outbreaks of infections have been traced to the artificial fingernails of health care workers. For those reasons they are prohibited for anyone having patient contact. See above.

Nails are to be kept clean and short. They should not extend past the fingertips.

Studies have shown that hospital personnel with nail enhancements can have more bacteria both before and after hand washing than personnel with natural nails. Long natural nails can also harbor bacteria. See Other Resources above.

Gloves are not a substitute for hand washing and artificial nails may harbor organisms and prevent effective hand washing. Long nails, artificial or natural, may cause gloves to tear more readily. See Evidence-Based and Current Standards above.

Each employee has a responsibility for maintaining hand hygiene, which now includes the removal of artificial nails and trimming long, natural nails, as defined by the policy. Managers will ensure that these standards are maintained. Additionally, the UCSF Medical Center will, in 2007, roll out a comprehensive hand hygiene campaign that will include education and monitoring to ensure that all staff are complying with existing hand hygiene policies, including the length and condition of nails.

The doctor caring for the patient is responsible for placing the skin test. The doctor must first write an order in the chart for the tuberculin skin test and controls. The PPD and control will be sent to the floor in a multiple use vial. 0.1 ml should be drawn into a tuberculin syringe, and the test placed on the patient. The vial should be dated, then stored under refrigeration and protected from light. The remaining contents of the vial are good for 30 days when stored in this manner. If controls are desired, the order needs to specify which control(s) is to be used. Candida and mumps are the usual controls; tetanus is sometimes used. These three are all available in the pharmacy. Coccidioides has been used as a control, but it is not available nor stocked in the pharmacy. If you have questions, please call the pharmacy at (415) 353-1028.

You must first obtain a medical clearance, usually from Employee Health Services or other health care provider. Then call EHS at 476-1300 to make an appointment. Appointment times are available on Thursdays between 1:00 PM and 4:00 PM. Complete details can be found in “Respiratory Protection Program” found in the Aerosol Transmissible Disease Exposure Control Plan.

Isolation signs can be ordered by contacting WorkflowOne (formerly Realizon) and providing the product numbers listed below for the signs you need. Product numbers are also listed on the back of each sign at the bottom. Material Services also has a limited supply of precaution signs if needed quickly. They can be ordered using the online ordering tool along with your other supplies.

These signs reflect the revised Standard and Transmission-based Precautions policy. If your department still has old versions of the isolation signs, please discard them and order the new ones. Please contact us if you have any problems ordering these signs. 

Inpatient Airborne Isolation: Product Number: 500-0137

Inpatient Droplet Isolation: Product Number: 500-0140

Inpatient Contact Isolation: Product Number: 500-0139

Inpatient Enteric Contact Isolation: Product Number: 500-0577

Inpatient Novel Respiratory: Product Number: 500-0578

Inpatient Combo Droplet-Contact: Product Number: 500-0579

Inpatient Combo Airborne-Droplet: Product Number: 500-0600

Inpatient Combo Airborne-Contact: Product Number: 500-0601

Inpatient Combo Airborne-Contact-Droplet: Product Number: 500-0602

Inpatient UCSF Precautions/Cystic Fibrosis: Product Number: 500-0135

Material Services has a limited supply of "Wash your Hands with Soap and Water on Exit" sign if needed quickly. They can be ordered using the online ordering tool along with your other supplies. Please use PMM# 58963.

Wash your hands with soap and water on EXIT: Product Number: 500-0450

In patient care areas, including nurses stations, adult inpatient units and patient examination and treatment rooms in the outpatient practices, only cleaning supplies (e.g., Sani-Cloth) are allowed under sinks. In pediatric units where under sink storage areas are accessible by children, cleaning solutions must not be stored under sinks. Items such as vases and non-paper products are allowed under sinks in areas such as staff lounges and conference rooms. Binders and office supplies should not be stored under sinks. Patient care items are specifically prohibited from being stored under sinks.

At this time, Standard are required for patients with methicillin-resistant Staphylococcus aureus (MRSA).