Skin Tears Research Articles

Efficacy of a Skin Tear Education Program

We sought to evaluate the knowledge base of acute care registered nurses (RNs) regarding skin tears and the efficacy of an online educational program designed to improve their knowledge of skin tears including (1) predisposing factors; (2) identification and assessment of skin tears using the Payne-Martin Classification System; and (3) preventive care, treatment, and documentation. This was a prospective quasi-experimental education intervention study. Four hundred sixteen acute care RNs from 2 affiliated hospitals participated in the study. They comprised approximately 20% of more than 2,000 nurses employed by Atlantic Health. These nurses worked in critical care, medical-surgical, and specialty units and varied in age, level of education, work experience, and years in nursing. A Web-based educational program was provided for over 4 months on our intranet service, which was available to all RN staff 24-hours-a-day, 7-days-a-week. The educational program was subdivided into 3 sections: (1) identification and assessment, (2) classification and differentiation, and (3) treatment. Nurses' knowledge of skin tears improved following the Web-based educational program. Following completion of the identification and assessment of skin tears section, participants were better able to identify and correctly assess skin tears (mean scores 99.1% vs 97.1%, P < .001). Participants also achieved greater knowledge of the differentiation between categories I, II, and III skin tears (mean scores 94.9% vs 83.4%, P < .001) and knowledge of treatment (mean score 93.7% vs 73.8%, P < .001). Our Web-based skin tear educational program was effective in improving nurses' knowledge regarding skin tear identification and assessment, classification and differentiation, and treatment.

Prevention and Management of Skin Tears

In Brief PURPOSE To provide the wound care practitioner with evidence-informed information on the prevention and management of skin tears. TARGET AUDIENCE This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. OBJECTIVES After reading this article and taking this test, the reader should be able to: Identify risks and causes of and a classification system for skin tears. Discuss the treatment and prevention of skin tears. In this continuing education activity, the authors review the risks and causes of skin tears, a classification system, and treatment and prevention strategies.

Prevention and Management of Skin Tears

Prevention and Management of Skin Tears

Infraorbital Dark Circles: Definition, Causes, and Treatment Options

Infraorbital dark circles refer to the conditions that present with darkness of the infraorbital eyelids. Although it is not a medical concern, it can be a cosmetic concern for a large number of individuals. Moreover, clear definition and possible causes have not been elucidated. To review the possible causes and treatment options for infraorbital dark circles. The article is based on a review of the medical literature and the author's clinical experience in treating infraorbital dark circles. Possible causative factors of infraorbital dark circles include excessive pigmentation, thin and translucent lower eyelid skin overlying the orbicularis oculi muscle, and shadowing due to skin laxity and tear trough, but because multiple factors cause infraorbital dark circles in the majority of patients, it is essential to identify the cause and choose the appropriate treatment according to the cause.

Professional Practice-Computer Software Applications

This prospective educational intervention research study identifies the existing knowledge base of a sample of 416 practicing acute care nurses regarding skin tears and evaluates the efficacy of an educational program designed to improve these nurses' knowledge regarding skin tears including: (1) predisposing factors; (2) identification and assessment of skin tears using the Payne Martin Classification System; and (3) preventive care, treatment and documentation regarding skin tears. A pretest baseline measurement of acute care nurses' skin tear knowledge and a postintervention posttest measurement of changes in these nurses' skin tear knowledge were obtained following an online educational intervention. The Web-based skin tear educational program was effective in delivering new knowledge to these nurses. Study results indicate a highly significant (P = .001) improvement between pre- and posttest scores for all three categories of skin tear knowledge studied: (1) identification and assessment of skin tears (97.1% to 99.1%); (2) the Payne Martin Classification system (83.4% to 94.9%); and (3) skin tear treatment (73.8% to 93.7%). The results of this study demonstrate that there is a need to have a consistent skin tear identification tool and treatment protocol in place for standardized evidence-based practice among nurses in an acute care setting. We recommend: (1) uniform skin tear education for all acute care staff nurses; (2) that the Payne Martin Skin Tear Classification System be used for skin tear documentation on all medical/surgical units; and (3) that product availability for the standardized treatment skin tears and a skin tear treatment protocols be available for nurses to follow. Additionally, educational support should be readily available for staff nurses and patient care technicians regarding prevention strategies for skin tears.

The prevention and management of skin tears

Menna Lloyd-Jones discusses the important role that care assistants can play in preventing and managing skin tears, which are a painful commmon problem for frail older people.

Clinical Implications of Aging Skin

Aging skin undergoes progressive degenerative change. Structural and physiologic changes that occur as a natural consequence of intrinsic aging combined with the effects of a lifetime of ongoing cumulative extrinsic damage and environment insult (e.g. overexposure to solar radiation) can produce a marked susceptibility to dermatologic disorders in the elderly. As skin ages, the vasculature progressively atrophies. The supporting dermis also deteriorates, with collagen and elastin fibers becoming sparse and increasingly disordered. These changes leave the elderly increasingly susceptible to both vascular disorders such as stasis dermatitis and skin injuries such as pressure ulcers and skin tears, with a steadily decreasing ability to effect skin repair. A parallel erosion of normal immune function produces higher levels of autoimmune skin disorders such as bullous pemphigoid, benign mucous membrane pemphigoid, paraneoplastic pemphigoid, and pemphigus vulgaris. Lichen sclerosus, an autoimmune disorder often occurring in the genital area in older women, is not common but is an important development because of the potential for substantial discomfort as well as serious complications. The prevalence of polypharmacy in this population increases the risk for autoimmune drug reactions, and diagnosis should be undertaken with an awareness that polypharmacy in this population creates a greatly increased susceptibility to drug eruptions that can mimic other cutaneous disorders. Immunologic senescence in the elderly also sets the stage for potential reactivation of the Varicella zoster virus, in which initial dermatologic involvement expands into the major sensory ganglia. Known as shingles, this disorder can be excruciatingly painful with the potential to cause blindness if the optic nerve becomes involved. Dermatoses such as xerosis, pruritus, and eczema are also widespread in the elderly, create substantial suffering in those afflicted, and often prove recalcitrant to treatment. Individual susceptibility to specific types of contact dermatitis changes over the lifetime, and seborrheic dermatitis is substantially more prevalent in the elderly. It is not uncommon for older patients to have multiple impairments, with the potential for cognitive dysfunction as well as impaired vision, hearing, or mobility. In addition, they may not have adequate housing or nutrition, or the financial resources necessary for adequate compliance. Physicians must take into consideration the patient's physical ability to comply with the recommended therapy as well as socioeconomic factors that may impact on compliance. Simple topical regimens are preferable wherever possible in order to maximize compliance and, therefore, efficacy. Extra effort may be necessary to ensure that instructions are accurately followed and that ongoing compliance with the regimen prescribed is actually achieved. Management of dermatologic disorders in the elderly is often less than optimal, due to the fact that the special needs and limitations of this population are not adequately considered. Treatments should consider the intrinsic differences between younger and older patients that may impact on diagnosis and therapy choice. The aged patient is often afflicted with numerous co-morbidities that can influence the choice of therapy. Skin integrity in the elderly is compromised, and safety concerns are increased with the long-term use of any medication prescribed. In addition, the prevalence of polypharmacy in the aged population substantially increases the risk of cutaneous drug reactions, which can profoundly complicate accurate diagnosis of dermatologic disorders. The aged population also needs to be more closely monitored because of increased fragility of the skin and the physical limitations that may hinder compliance with prescribed regimens.

Readily Available MDS Data Can Improve Pain Assessment in Residents With Dementia

Readily Available MDS Data Can Improve Pain Assessment in Residents With Dementia

The prevention and management of skin tears

Healthcare assistants and assistant practitioners often work very closely with patients. It is therefore important to have a good understanding of skin tears so that they can be minimized or avoided completely where possible. This article outlines the different types of skin tears, lists the risk factors and explains how to treat them.

&lt;b&gt;Skin Tears: Prevention and Treatment&lt;/b&gt;

While skin tears are common among the elderly in general, and residents of long-term care facilities in particular, there has been limited research into their treatment. Many facilities voluntarily track skin tears, and some states require facilities to report these events. Risk factors include age, xerosis (abnormal eye, skin, or mouth dryness), need for help in activities of daily living, presence of senile purpura, visual impairment, and poor nutrition. Plans to prevent skin tears that employ skin sleeves, padded side rails, gentle skin cleansers, moisturizing lotions, as well as staff education, can decrease by half the number of skin tears incurred in a long-term care facility. Although the treatment process seems simple, it is time consuming and can be painful for the patient. Residents with dementia or agitation often try to remove bulky dressings used to cover skin tears. Dressing changes may injure the fragile wound via skin stripping.

EVIDENCE-BASED SKIN TEAR PROTOCOL YIELDS PHENOMENAL RESULTS

PROBLEM Skin tears are an often overlooked wound type in skilled nursing facilities. Long term care documentation requirements classify skin tears as accidents and may have contributed to the perception that skin tears are not “real” wounds. Facilities’ wound care protocols often lack treatment guidelines for skin tears. Facilities need an effective evidence-based protocol for the prevention and treatment of skin tears that is scientifically rigorous and practical enough to be of value for education of all members of the clinical care team. RATIONALE An ideal skin tear protocol: addresses regulatory and in servicing needs; can be used by everyone in the facility regardless of their level of clinical training; facilitates patient and family education by licensed staff; is evidence-based; and ensures outcomes consistent with the facility’s quality of care standards related to infection and wound resolution. Polymeric membrane dressings* meet all evidence-based criteria regarding dressing choices for skin tears, so the new protocol includes using these unique dressings.

Preventing and Treating Skin Tears

Q: What causes skin tears and how are they best treated?A: Skin tears are traumatic wounds that result from a separation of the 2 major layers of human skin, the epidermis and the dermis. They represent a major problem affecting older adults and many compromised individuals. It is estimated that at

Preventing and Managing Skin Tears

Skin tears are an increasingly common problem in frail elders, and the wound, ostomy, and continence (WOC) nurse must be knowledgeable regarding both prevention and management of these lesions. A literature review was conducted to identify current concepts regarding management of skin tears. Articles reviewed provided numerous suggested interventions and protocols. Recurring themes were prevention of skin tears whenever possible and management of existing lesions with products that manage the exudate, maintain a moist surface, and prevent additional trauma.

Promoting The Patient's Dignity And Preventing Caregiver Injury While Caring for A Morbidly Obese Woman with Skin Tears And A Pressure Ulcer

Expressing compassion is a universal nursing value, but the inability to adequately provide safe, competent care threatens the very essence of nursing. We report a clinical situation wherein nurses and other clinicians were given appropriate tools and resources necessary to care for a very medically complex morbidly obese patient. The role of dignity in managing the needs of patients, families, and caregivers is discussed. Common obesity-related skin challenges are described. Strategies for preventing caregiver injury while promoting patient safety, including prevention of skin injury, are presented. The input of nurses in performance improvement efforts can serve as a catalyst to implementing a hospital-wide process in which satisfaction, cost, and therapeutic outcomes are addressed as indicators of improved care.

Caiman Bite

Caiman crocodilus, commonly called the spectacled caiman, is a very widely distributed resident of the western-hemisphere wetlands. Caiman bites to humans can cause trauma and infection. There are few reports of caiman bites; however, there is information about bites by other members of the same family, including Alligator mississippiensis. A case of acute caiman bite to the hand is described, including initial treatment and outcome. The bite resulted in multiple lacerations, interarticular fracture, and infection. One of the lacerations was closed, and the patient was started on moxifloxacin hydrochloride. Preventive care and treatment including wound care and antibiotics are discussed. The patient recovered with only a slight long-term functional deficit.

High-Tech Devices Show Long-Term Potential

High-Tech Devices Show Long-Term Potential

Skin Tears?

Skin Tears?

AB17-3: Prevention of adhesive skin tears from pressure dressings following pacemaker/defibrillator implantation

Following pacemaker or defibrillator implantation, pressure dressings are commonly used to help ensure hemostasis and reduce device pocket edema. In general, patients receiving these types of devices tend to be older, and therefore, at greater risk for skin injury. A skin prep is needed to anchor the elastic tape. Unfortunately, during dressing removal, the elastic tape can often cause adhesive skin tears. This is obviously both painful to the patient and increases infection risk with the disruption in skin integrity.

Root cause analysis for tissue viability incidents

Introduction The terms untoward incident, adverse event, serious untoward incident, critical incident and patient safety incident are all used by different agencies and individuals with slightly differing emphasis and definition. In England and Wales, the National Patient Safety Agency [NPSA) defines a patient safety incident as 'any unintended or unexpected incident which could have, or did, harm a patient ... . In tissue viability fields, examples of patient safety incidents could include pressure ulcers, wound infections, skin tears caused by handling, rashes caused by medication, and unexpected deterioration of leg ulcers.

Preventing and treating skin tears

Skin tears are a common problem in frail older people, yet nurses often lack guidance in how to treat them. Linda Nazarko explains what you need to know.