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ADVICE, P.R.N.: HAND HYGIENE

Rings on or off?

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I like to wear several rings, including my wedding band. Should I remove them when I clean my hands between patients?—L.N., ME.

Although most research shows that bacterial colonization is much greater on ringed than bare hands, ring removal for routine hand hygiene isn't recommended by the Centers for Disease Control and Prevention (CDC). The current guidelines, published in October 2002, cite research that found that “rings were the only substantial risk factor for carriage of Gram-negative bacilli and Staphylococcus aureus and that the concentration of organisms recovered correlated with the number of rings worn.” Even so, the guidelines state that more research is needed to establish whether wearing rings increases the transmission of pathogens.

Our infection control consultant says it should go without saying that multiple or heavy rings can't be thoroughly cleaned by even diligent hand hygiene, nor can the skin beneath them. For these reasons, some facilities have policies against wearing anything but a wedding band. Even if your facility has no policy on rings, use common sense. Avoid cumbersome rings and clean your hands meticulously. One recent study on ring wearing and hand hygiene found that using alcohol-based hand rubs reduced contamination better than soap and water. For more information on hand hygiene and infection control, visit the Web sites for the CDC (http://www.cdc.gov) and the Association for Professionals in Infection Control and Epidemiology (http://www.apic.org).

References

“Guideline for Hand Hygiene in Health-Care Settings,” Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention, October 25, 2002.
    “Impact of Ring Wearing on Hand Contamination and Comparison of Hand Hygiene Agents in a Hospital,” Clinical Infectious Diseases, W. Trick, et al., May 22, 2003.
      © 2004 Lippincott Williams & Wilkins, Inc.