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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All Saints’ Day Blessing for Health Care Providers

Autumn Angel / photo by Julianna Paradisi 2016 Autumn Angel / photo by Julianna Paradisi 2016

November is the strangest of months. Its days are shorter, darker. It begins with All Saints’ Day, a day of remembering our dead, of loss and grief, followed late in the month by Thanksgiving, America’s celebration of abundance with gratitude.

This year on All Saints’ Day I attended a discussion of health care professionals. The audience included nurses, physicians, pharmacists, social workers, and hospital administrators. The conversation ultimately centered on the emotional difficulties of patient care.

It wasn’t a debriefing as much as collective acknowledgment that, rather than accepting help, some patients or their family members view us as the enemy, sometimes disrupting our best efforts in the name of misguided advocacy.

Nurses spoke of being labeled as “bad” and played against each other by angry patients or family members. Physicians related episodes of verbal abuse from patients or family members demanding inappropriate procedures, medications, or dosing. Some spoke of needing to take refuge to center their thoughts before ordering the appropriate care.

Like most nurses, I’ve experienced similar treatment at the hands of difficult patients, but physicians don’t generally discuss with us how they are treated. Nurses and physicians suffer silently, instead of lending support […]

2016-11-21T13:00:49-05:00November 10th, 2016|Nursing, Patients|1 Comment
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AJN November Issue News: Maternal Mortality, Nurses’ Salaries, Double Mastectomy, More

AJN’s monthly news section covers timely and important research and policy stories that are relevant to the nursing world. Here are some of the stories you’ll find in our current issue (news articles in AJN are free access):

Photo by Dennis MacDonald / Alamy Stock Photo. Photo by Dennis MacDonald / Alamy Stock Photo.

Maternal Mortality in U.S. on the Rise

In 48 states and the District of Columbia, the maternal mortality rate increased by 26.6% between 2000 and 2014. (Texas was analyzed separately; its rate doubled between 2010 and 2012.) California–which saw a decline in maternal deaths–was the exception. While there’s no clear cause for the increase, researchers have several ideas about factors that may have prompted it.

Salaries for Nurses Decrease, While NP Salaries Rise

According to a survey of 20,000 health care workers, compensation for nurses decreased 3.1% between 2015 and 2016; NPs reported a 5.3% […]

2016-11-21T13:00:49-05:00November 9th, 2016|Nursing|0 Comments
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Hitting the Nursing Conference Trail: Many Miles, But Much to Inspire

“Nurses are doing such interesting and important work.”

A big part of what we do at AJN is seek out the latest information and compelling stories to bring to readers each month. That often means a lot of traveling. While sometimes it does get a bit much (conferences are mostly clustered in the spring and the fall), I’ve come to enjoy traveling—nurses are doing such interesting and important work!

Here’s a recap of some recent travels:

Nursing Research

2016-11-21T13:00:52-05:00November 2nd, 2016|Nursing|0 Comments
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AJN in November: Skin Tears, Veteran Women’s Mental Health, Supporting Family Caregivers, More

The November issue of AJN is now live. Here are some articles we’d like to bring to your attention.

ajn1116-cover-onlineCE Feature: “Preventing, Assessing, and Managing Skin Tears: A Clinical Review”

Although skin tears are common, particularly among older adults and neonates, they are often inadequately documented and poorly managed, resulting in complications, extended hospital stays, and negative patient outcomes. In this article, the first in a series on wound care in collaboration with the World Council of Enterostomal Therapists, the authors describe the complications that developed in an elderly patient whose skin tear was improperly dressed and discuss best practices for preventing, assessing, documenting, and managing skin tears.

CE Feature: “Veteran Women: Mental Health–Related Consequences of Military Service”

The last two decades have seen increasing numbers of women entering all branches of the U.S. armed forces. Many are exposed to traumatic events that place them at higher risk for mental health conditions. It’s essential for all nurses to be knowledgeable about the mental health issues commonly seen in this population. The author of this article reviews research confirming that both active-duty and veteran women are at increased risk for postdeployment mental health problems, including posttraumatic stress disorder, military sexual trauma, and suicide—and also addresses the nursing practice implications, […]

2016-11-21T13:00:52-05:00October 28th, 2016|Nursing|0 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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