Taking Skin Tear Prevention and Management Seriously

In the Past, Approaches to Skin Tears Were Inadequate

Many years ago, when I worked in a skilled nursing facility, it seemed my patients were always experiencing skin tears. We didn’t have wound care specialists then. My approach to these injuries, which I didn’t see as serious, was to cleanse them with saline and awkwardly attempt to reposition the detached flap. In retrospect, the nursing care I provided didn’t amount to much more than “a lick and a promise.”

Greater Awareness of Risks, Dangers of Skin Tears

screen-shot-2016-11-14-at-6-09-55-pmToday, we know that skin tears can evolve into serious, complex wounds. Available data indicate that in long-term care settings, these injuries affect up to 22% of residents. Wound care specialists have developed a classification system for skin tears—as for pressure injuries, specific recommendations from wound care specialists guide our nursing care.

In this month’s AJN, author Sharon Baranoski and colleagues from the International Skin Tear Advisory Panel detail the assessment and management of skin tears in “Preventing, Assessing, and Managing Skin Tears: A Clinical Review.” While the authors emphasize the need to involve wound care nurses in the management of these injuries, many readers may find the product selection guide in this article to be especially useful.

2016-11-21T13:00:49-05:00November 14th, 2016|Nursing|3 Comments
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How a Busy Hospital Reduced Its Rate of Hospital-Acquired Pressure Ulcers to Zero

By Sylvia Foley, AJN senior editor

A skin lesion monitoring form accompanies a patient. Photo courtesy of NHCH. A skin lesion monitoring form accompanies a patient. Photo courtesy of NHCH.

In 2009, when one of the world’s largest cardiac care hospitals experienced a spike in the number of surgeries performed and a corresponding rise in hospital-acquired pressure ulcers, many people were concerned. The hospital—Narayana Hrudayalaya Cardiac Hospital (NHCH) in Bangalore, India—soon initiated a program to address the problem, and nursing superintendent Rohini Paul was tasked with designing and implementing effective preventive strategies. In this month’s CE feature, “Sustaining Pressure Ulcer Best Practices in a High-Volume Cardiac Care Environment,” Paul and colleagues describe what happened next. Here’s a brief overview.

Baseline data showed that, over the five-month observation period, an average of 6% of all adult and pediatric surgical patients experienced a pressure ulcer while recovering in the NHCH intensive therapy unit (ITU). Phase 1 implementation efforts, which began in January 2010, focused on four areas: raising awareness, increasing education, improving documentation and communication, and implementing various preventive practices. Phase 2 implementation efforts, which began the following month, focused on changing operating room practices. The primary outcome measure was the weekly percentage of ITU patients with pressure ulcers.
By July 2010, that percentage was reduced to zero; as of April 1, 2014, the hospital has maintained this result. Elements that contributed significantly to the program’s success and sustainability include strong leadership, nurse and physician involvement, an […]

2017-07-27T14:45:11-04:00August 8th, 2014|nursing perspective|7 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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