Nail Polish & USP 797

Question:

Current 797 does not prohibit nail polish, but the new 797 draft does prohibit nail polish.  What should a surveyor look for when compounding staff have nail polish?

Answer:

It is correct that the 2008 version of USP Chapter 797 is silent about nail polish. It does prohibit artificial nails and extenders, however, and it does require neatly trimmed nails. 

The proposed new 797 does specifically prohibit nail polish. 

Nail polish and nail gels have been subject to analysis by groups such as AORN and APIC and many hospital policies prohibit polish and gels for high-risk areas such as the operating room, central sterile processing, sterile compounding, and even direct patient care. 

Thus, we know that there is potential risk, and we know that there is expert advice against gels and polish use. 

The routine question TJC would ask is: Have you conducted a multidisciplinary risk assessment analyzing the literature and current hospital practices in other high-risk environments in the organization to determine if current practice is safe and approved? 

Absent a documented risk assessment that concludes the process is safe and consistent within the organization, it could be a scoreable issue.