RBG: Regular, Bare, Gel: Does Type of Nail Polish Affect Bacterial Counts After Surgical Scrubbing?

Study Overview
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Brief Summary
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Purpose: The purpose of this study is to evaluate if type of nail polish (gel polish or regular polish) has an effect on the number of bacterial colonies on finger nails after surgical scrubbing. Participants: The potential participants are healthcare providers with patient interaction. Exclusion criteria include evidence of active dermatitis or other skin abnormalities, or allergy to chlorhexidine. Intervention: Participants will have gel nail polish applied to one finger of their dominant hand, and regular polish applied to another finger of their dominant hand. Bacterial swabs will be collected from these two fingers, as well as the from the adjacent finger with no nail polish. Specimen collection will occur both before and after scrubbing with surgical soap. Bacterial counts will be compared between the three groups to determine the association between the presence of nail polish and nail polish type on bacterial counts after surgical scrubbing. Specimen collection will not take place during scrubbing for actual patient care.

Detailed Description
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Potential participants will be identified by word of mouth, flyers and institutional networking. Once a participant agrees to enroll, they will have each type of nail polish placed on a single finger on their dominant hand (gel on one finger and regular polish on another). A third finger will be left bare to serve as a control. On day 1-3 after nail polish application, the participant will have cotton swab samples taken from underneath their nail and over their nail bed, on each of the two polished nails, as well as the adjacent bare nail. These bacterial samples will be collected both before and after scrubbing (utilizing a nail pick, scrub brush, and chlorhexidine). This process will be repeat on day 5-7 after nail polish application. These samples will then be assessed for bacterial colonies in the Microbiology laboratory. Participant variables will be recorded in RedCap (scrubbing frequency, % of chipping in nails (in quartiles: 0, < 25%, < 50%, <75%, >75%, Gender, Age, Level of training, Specialty, Type of polish, Dominant hand, Duration since application of polish, Nail length in mm, Race, BMI, Type of bacteria isolated from samples). Summary of Study Visits: Day 0 Participants will have polish applied on two fingers on their dominant hand, one with gel polish and one with regular polish. Day 1-3 The participants will return for their first swabs. Bacterial swabs will be obtained from the nail bed and under the fingernail of 3 fingers: the regular polish nail, the gel polish nail and a bare nail adjacent to the two polished nails, before and after a standard 5-minute scrub with chlorhexidine. Day 5-7 The participants will return for the same procedure described above. The nail polish can be removed after this intervention. No further follow-up or involvement for participants

Official Title
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RBG: Regular, Bare, Gel: Does Type of Nail Polish Affect Bacterial Counts After Surgical Scrubbing?

Conditions
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Bacterial Infections, Surgical Site Infection, Contaminated Medical or Biological Substances

Intervention / Treatment
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* Other: Nail polish application


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Healthcare provider who provides patient care Exclusion Criteria: Active dermatitis or other skin abnormality Allergy to chlorhexidine scrub soap

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: All participants will have all three nail types assessed: regular polish, gel polish and bare nail
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Regular Nail Polish<br>Participants will have regular nail polish applied to one fingernail of their dominant hand | Other: Nail polish application<br>* After application of nail polish as described, participants will have bacterial swabs collected from the under the fingernail and from the nail bed of the three assigned fingers on their dominant hand, both before and after scrubbing with a chlorhexidine surgical scrubbing brush.<br>|
| Experimental: Gel Nail Polish<br>Participants will have gel nail polish applied to one fingernail of their dominant hand | Other: Nail polish application<br>* After application of nail polish as described, participants will have bacterial swabs collected from the under the fingernail and from the nail bed of the three assigned fingers on their dominant hand, both before and after scrubbing with a chlorhexidine surgical scrubbing brush.<br>|
| No Intervention: Bare Nail<br>Participants will have one fingernail of their dominant hand left bare for comparison | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Bacterial Counts Before Scrubbing Day 1-3 | Bacterial colony counts will be measured from each swab obtained from the three types of fingernails (regular polish, gel polish, bare nail). | 1-3 days after polish application | 
| Bacterial Counts After Scrubbing Day 1-3 | Bacterial colony counts will be measured from each swab obtained from the three types of fingernails (regular polish, gel polish, bare nail). | 1-3 days after polish application | 
| Bacterial Counts Before Scrubbing Day 5-7 | Bacterial colony counts will be measured from each swab obtained from the three types of fingernails (regular polish, gel polish, bare nail). | 5-7 days after polish application | 
| Bacterial Counts After Scrubbing Day 5-7 | Bacterial colony counts will be measured from each swab obtained from the three types of fingernails (regular polish, gel polish, bare nail). | 5-7 days after polish application | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percent of nail polish flaking (%) Day 1-3 | Percent of nail polish flaking (%) will be measured for each type of polish | 1-3 days after polish application | 
| Percent of nail polish flaking (%) Day 5-7 | Percent of nail polish flaking (%) will be measured for each type of polish | 5-7 days after polish application | 
| Nail growth (mm) Day 1-3 | Nail growth (mm) will be measured for each group | 1-3 days after polish application | 
| Nail growth (mm) Day 5-7 | Nail growth (mm) will be measured for each group | 5-7 days after polish application |