Prevalence and correlates of skin damage on the hands of nurses

OBJECTIVE: To describe the prevalence and correlates of skin damage on nurses' DESIGN: Prevalence survey using: self-report questionnaire of hand care regimens, problems, and skin condition, and visual examination of the hands at 30X magnification by trained investigators to evaluate degree of skin scaling. SETTING: Four hospitals: two in the Mid-Atlantic and two ill the northern United States. PARTICIPANTS: Convenience sample of 410 nurses working 30 hours or more per week in acute care units. OUTCOME MEASURES: Damage to skin of the hands. RESULTS: Approximately one fourth of subjects (n = 106) mel the criteria for currently damaged hands; 85.6% (n = 351) reported ever having skin problems. Damage was not correlated with age (p = 0.43), sex (p = 0.14), or skin type (p = 0.25), type of soap used at home (p = 0.58), reported duration of handwashing (p = 0.12), or glove brand (p = 0.90), but was significantly correlated with the type of soap used at work (p = 0.01), number of hand washes per shift (p = 0.0003), number of times gloves were worn (p = 0.008), and study site (p = 0.009). Variables significantly predictive of skin damage in a logistic regression analysis were type of soap used at work and number of times gloves were worn (p = 0.04). Geographic location was not a factor, because both the highest and lowest prevalence of skin damage occurred in the northern study institutions. CONCLUSIONS: Damage to skin of the hands is a common and potentially serious problem among nurses, and is associated with gloving and handwashing practices rather than with geographic or demographic factors. Efforts to improve skin condition must focus on improving products and identifying any interactive effects between hand care products and glove materials and brands.