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Abstract The use of jewelry among healthcare professionals poses a risk of cross contamination due to potential bacterial accumulation and spread. Through a mixed-method design, this study first analyzed the implications of healthcare professionals wearing jewelry on patient care biosafety as well as on the residual bacterial load of hands and rings after hand hygiene. Firstly, an observational prevalence study to verify whether nursing professionals wear personal accessories during healthcare assistance was carried out. Second, an experimental design involving intentional contamination and hygiene of the hands, with and without a ring, was conducted. The bacterial load of both hands and rings was measured by counting colony forming units. The observational study showed that nursing workers frequently wear jewelry during healthcare assistance. Nonetheless, the experimental study did not indicate differences in bacterial contamination between hands with and without a ring, despite the hand hygiene procedure applied. In conclusion, many nursing workers wear jewelry in the workplace. Although hands with and without a ring exhibited similar microbial load, rings appeared as a potential source of bacterial contamination, reinforcing the need to remove jewelry during working hours. Hand hygiene using alcohol, or soap and water significantly decreased the bacterial load on the participants’ hands, with handwashing proving to be the most efficient method for removing intentional contamination.

The disinfection procedures aim to reduce the microbial load, but there are doubts about the risks of contamination spreading into the lumens of devices, such as three-way stopcocks (3-WS). This study aimed at an in vitro evaluation of the antibacterial procedure of manual friction of 3-WS intentionally contaminated and to determine the solution dispersion into the lumens. Laboratory experiments were developed in two steps: evaluation of bacterial spread through intentional contamination with Staphylococcus aureus and Pseudomonas aeruginosa, and alcohol dispersion into the 3-WS lumens. After manual friction of the 3-WS with saline solution at 0.85% (w/v) [control group], S. aureus and P. aeruginosa were isolated in the lumens of 55.6% and 27.8% of the devices, respectively. However, after the disinfection of the 3-WS with ethyl alcohol at 70% (w/v), there was no bacterial contamination in the lumens of the 3-WS. On the other hand, the solution dispersion (dye) into the lumens was evidenced by two different techniques: Durham tubes (5.6%) and swabs (46.3%). The manual friction of the 3-WS with ethyl alcohol at 70% demonstrated antibacterial efficacy, but it refers to reflections on the risk of solution diffusion into the venous network and the inherent clinical practice situations and patient safety.