Why it matters in senior living
Many residents in senior living have chronic health conditions, fragile skin or immune systems that don’t fight infection as well as they used to. Nail tools touch skin, and sometimes break it. If tools aren’t cleaned and disinfected properly, they can carry germs from one person to the next. That is why infection control should be the first thing you ask any nail care provider about, not the last.
The questions below are a starting point. Your infection preventionist or director of nursing may want to add their own.
Questions about tools
How are reusable tools cleaned and disinfected between residents?
Listen for a clear, step-by-step answer. Tools should first be cleaned to remove visible debris, then disinfected in an EPA-registered disinfectant used exactly as the label directs, including the full contact time. Afterward, they should be stored in a clean, closed container until they are used again. Vague answers like “we wipe everything down” are not enough.
Which disinfectant do you use?
A provider should be able to name the product. You can check that it is EPA-registered and read its label for what it is effective against and how long it must stay wet on a surface. If your policies require it, ask for the product’s safety data sheet.
Do you bring enough tools for every resident?
Disinfection takes time. A provider who brings one set of tools for a full day of residents may be tempted to cut contact time short. Ask how many sets they bring and how they rotate them.
What do you use only once?
Porous items can’t be properly disinfected. Nail files, buffers, wooden sticks, toe separators and similar items should be new for each resident and then thrown away, or left with that resident for their own use only.
Questions about foot care
Do you use foot baths or soaking basins?
Shared foot basins are hard to clean thoroughly between people. For at-risk residents, a safer approach is dry care, or single-use liners that are thrown away after each person. Ask what the provider does and why.
How do you handle residents with diabetes or poor circulation?
The answer should involve your facility’s policy and the resident’s care plan. A good provider will ask about these before the first visit and will defer to the resident’s podiatrist where the care plan calls for it.
Questions about hands, gloves and the workspace
What do you do between residents?
Ask about hand hygiene and gloves. Hands should be cleaned between every resident, and gloves, if used, changed each time. Any towel or barrier on the work surface should be fresh for each person.
How do you set up in a resident’s room?
In-room care is common in senior living. Ask how the provider sets up a clean work area on a bedside table or tray, how used items are bagged and removed, and how they avoid carrying anything from one room to the next.
What happens if a resident is nicked or cut?
Small nicks can happen, especially with fragile skin. Listen for an answer that includes stopping, following your community’s first-aid procedure, telling nursing staff right away, and setting the tool aside for cleaning and disinfection before it is used again.
Questions about scope and communication
What do you do if you see signs of infection?
A nail technician should not work on an area that looks infected, and should not treat it. Redness, swelling, drainage, broken skin or unusual nail changes should be reported to nursing staff or the resident’s podiatrist. See our article on what a nail technician can and cannot do for more on where that line sits.
Will you follow our infection control policies?
The provider should follow your community’s policies, including during an outbreak, when you may need to pause visits or change where care takes place. Ask how they would handle a request to postpone.
Can we see your process?
It is reasonable to ask a provider to walk your nursing staff through their setup and disinfection process before the first visit, and to review each technician’s license and the provider’s certificate of insurance. Our guide on what to look for in a nail care provider covers licensing and insurance in more detail.
How we would approach it
At Skilled Nail Care, reusable implements are cleaned and disinfected between every resident in an EPA-registered disinfectant that is tuberculocidal and effective against HIV and Hepatitis B, then stored in a clean closed container. Files, buffers and wooden sticks are used once and discarded. For at-risk residents, pedicures are delivered dry or with single-use liners, never in a shared basin. We are nail technicians, not medical providers, and anything of concern would go to your nursing staff or the resident’s podiatrist. We would be glad to walk your staff through our process before any visit is booked.
This article is general information, not medical advice. Skilled Nail Care provides nail technicians, not medical providers.