Are facial piercings allowed in medical professions
German Society for Hospital Hygiene
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There are always heated discussions in hospitals, medical practices and old people's and nursing homes about wearing jewelry and piercing.
The DGKH would like to offer specialist information on this so that the problem can be dealt with objectively.
Finger / forearm jewelry
Wedding rings and jewelry rings, wristwatches, bracelets, friendship bracelets are not to be worn during activities that require hand disinfection. This is how the TRBA 250 (technical rule for biological agents) formulates it, and this is also seen from a hygienic point of view.
The reasons for this are:
- Rings increase the colonization of the hands with transient gram-negative bacteria and yeasts.
- Rings reduce the effectiveness of hand disinfection.
- Disinfectant residues may remain, which may cause skin irritation.
- Patient injuries can occur.
- Rings with stones or cuts perforate protective gloves. This means that the protective function - both for the staff and for the patient - is no longer guaranteed.
Situations that require hygienic hand disinfection occur recurrently in both care and medical work. This also applies to other professional groups (e.g. cleaning staff, "service assistants", MTAs, physiotherapists, RTAs) who have direct contact with patients. In this respect, the ban on wearing jewelry applies to all professional groups.
According to TRGS 401 (risk from skin contact) in point 188.8.131.52. Rings and jewelry on hands and forearms must not be worn during work for reasons of skin protection, as under the jewelry due to intense exposure to moisture
or hazardous substances the development of pathological skin changes is particularly favored.
Invisible piercing - e.g. belly button - is irrelevant.
Visible piercing on hands and forearms is to be regarded as jewelry and is prohibited (see above).
Visible piercing on other parts of the body - e.g. on the face - can lead to self-harm from a critical size if the (e.g. demented / confused) patient can grab it and tear it off. It is therefore forbidden for occupational safety reasons.
In general, piercing (not visible / visible) should be removed immediately in the event of reddening, swelling or secretion, as pathogens can be spread into the environment and thus patients can be infected.
Necklaces can contain sebum and skin residues and when they are loosened, this can lead to a direct entry of pathogens or to spreading the pathogen. In addition, necklaces can pose a risk to oneself if, for example, they are grasped by a demented / confused patient. Visible necklaces are therefore generally not permitted, but are at least prohibited in the operating theater and in intensive care units.
Small ear stickers are acceptable. Larger earrings are unacceptable as they can endanger yourself (e.g. tearing off by demented / confused patients).
Nail polish and (artificial) fingernails
Various studies show that nail polish and artificial fingernails promote colonization with potentially pathogenic germs and fungi. Transmission of pathogens with subsequent infections in patients has been reported.
Long fingernails can also lead to patient injuries. On the basis of these arguments, nail polish, artificial fingernails (including gel and Frenching, etc.) are generally prohibited if the staff has direct contact with the patient.
Natural fingernails are short and clean to wear.
Tattoos do not pose a hygienic risk to patients, unless the affected skin area is inflamed.
As early as 1995, in a warning procedure, it was judicially determined that the employer (hospital, etc.) can give binding instructions on the (non-) wearing of jewelry under occupational health and safety aspects (LAG Schleswig-Holstein, ruling of October 26, 1995, Az: 4 Sa 467/95).
In addition, it is at the discretion of a facility to make regulations on wearing jewelry, etc. that go beyond hygiene and occupational safety. For example, a ban on wearing jewelry or piercing can also be justified for reasons of corporate identity.
Consensus of the DGKH board 10.2010
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