February 2023 Wound and Ostomy Journal
Prevalence of Friction Skin Injury on the Buttocks and/or Posterior Thighs in an Acute Care Setting
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1. Discuss the sample size used in the study.
ReplyDeleteThe survey was conducted in a large academic medical center in the Midwestern United States. The hospital has 728 licensed beds and is a level 1 trauma center. 420 patients were available, and data were collected on 354 patients. 66 patients were excluded, 33 patients declined the survey, 25 were not on the units at the time of the survey, two were actively dying, and six patients were unstable for full skin assessment.
2. How does this research article compare to our practice, policy and/or procedure?
Our current practice includes Braden Scale Score per shift, initial full skin assessment on admission, wound care consultation for suspected skin issues, skin assessment throughout the shift, and proper wound care per order. Care for incontinence, moisture damage, proper wound care, and repositioning are critical in preventing pressure ulcers and assisting wound healing. We also have a team of nurses to audit on skin assessment and documentation. When pressure injuries develop, systems should be able to identify issues leading to their occurrence and implement methods for resolving these issues. There is increasing evidence that multidisciplinary interventions aimed at preventing pressure injuries in both acute care settings and long-term care facilities can have success in decreasing the prevalence or incidence rates of pressure injuries. This can include clinical staff becoming more involved at the patient care level, bundling and incorporating care practices into routine care, making documentation of pressure injury prevention practices more visible, and educating all staff regularly.
Bethany Sobesto 3/31/23
ReplyDeleteDescribe the method used by the author of the study.
The study used data from the quarterly NDNQI pressure ulcer prevalence study. 28 nurses and 5 patient care technicians assessed the skin of 354 patients in the hospital. The number of friction related injuries was focused on for this quality improvement initiative. The prevalence of friction skin injuries was calculated by taking the number of patients that had friction related injuries, divided by the number of patients surveyed.
Discuss the sample size used in the study.
In 2019, 354 patients were surveyed in this study. These patients were in an acute academic medical center, in the central plains of the United States. Of the 354 patients sampled, 8 were seen to have friction related skin injuries.
Describe the method used by the author of the study
DeleteWas the correct method used? Why or why not?
the data the author used was the location of damage, age and demographic, noted blanching or unbleachable. Then the analysis of prevalence as the number of patient counted in the study were used by the number of patient friction injury.
the sample size of the study was a big number, data collected was over 354 out of the 420 had available assessment, with counted for 83.8% if the study. Also 66 out of 420 patient were excluded. 8 out of 354 were identified for providing a prevalence rate of 2.3%.
The study method was correct, which created a quality improvement project for the facility for better outcome.
LeaU
ReplyDeleteWhat are the advantages and disadvantages to the proposed recommendations in the article?
One advantage to the proposed recommendation is a good clinical practice which is geared towards minimizing the impact of pressure, friction and the moisture on patients skin such as using the Braden score, knowledge of patients disease process and comorbidities and using appropriate tools and mechanism such as skin bundles to prevent skin injuries..an disadvantage to this recommendation is misinterpretation of the assessment of the skin such as pressure ulcer versus friction related skin injury.
Discuss the sample size used in the study?
354 patients were surveyed and these patients were in an acute academic medical center in Central plains . 8 patients have friction related skin injuries of the 354 patients surveyed.
Describe the method used by the author of the study
ReplyDeleteData collection method among assessed patients used by the author to measure friction skin injury (Fcl) prevalence include demographic characteristics, location of skin damage /lesions, skin color and weather they are blanchable or non blanchable. Dry skin ,pressure injuries and other wounds near Fcl were also considered. Fecal and urinary incontinence, use of absorbent pads, Braden scale, past medical history, mobility prior to admission and device for transferring and repositioning were also included.
Was the correct method used? Why or why not?
Yes, the correct method was used. By considering the above factors for her data collection, the author was able to state that the outcomes are similar in her clinical practice.Patients with multiple comorbid conditions contributing to weakness, decrease in mobility, decreased braden scale, moisture related increases the exposure of these patients to friction related risk during transfer and repositioning
1)What are the advantages/disadvantages to the proposed recommendations in the article?
ReplyDeleteThe focus of friction skin injury in the article certainly brings to light the importance of friction skin injury prevention as it relates to pressure injuries and their prevalence. Those individuals as mentioned that spend prolonged periods sitting in a recliner or in a reclining position in bed need a specific intervention care plan that is individualized for that pt taking into account mobility, moisture risk, and condition of skin.
2)Discuss the sample size used in the study
420 patients were available for assessment on Prevalence survey day for that hospital. 354 patients were included in the study. Of those patients, 8 patients were confirmed as having friction skin injury yielding a prevalence rate determined at 2.3%
1. Discuss the sample size used in the study.
ReplyDeleteThis article was written by a nurse that led this project based in the Wound Ostomy Services Department at a Level 1 Trauma Hospital in the MidWest. The study ultimately assessed 354 patients and found that 8 qualified for the study. A prevalence of 2.3%.
2. How does this research article compare to our practice?
The author explains that data on the patients was gathered during the quarterly skin survey- NDNQI. As the staff assessed skin head-to-toe and gathered data on each in-house patient, they were able to assess whether or not the patient had a friction skin injury. This made data collection easy and therefore allowed for the possibility of additional studies given it's prevalence. At PSJMC, the same event occurs with the quarterly skin survey and patients are assessed and data gathered. If need be, friction skin injury prevalence could easily be assessed. Currently there is not a quality improvement initiative for skin friction injury.
Discuss the sample size used in the study.
ReplyDeleteThe sample populatio was taken at a Midwestern hospital that contained 728 beds. there were 420 patient available on the day of survey assessment and data was collected from 354 patients.
Describe the method used by the author of the study.
This study was a Quality Improvement (QI) project used to measure FcI prevalence. the study collected data based on demographic characteristics, location of skin damage/lesion(s), and skin color and changes. There was also date collected based on fecal or urinary incontinence. Braden scores, patient mobility, and hospital length were addressed to determine outcome of the study.
1. Discuss the sample size used in the study.
ReplyDeleteIn the Midwest of the United States, a sizable academic medical center was where the survey was carried out. The hospital is a level 1 trauma center and has 728 licensed beds. There were 420 patients accessible, and 354 patients' data were gathered. 33 patients denied the survey, 25 were not on the units at the time of the survey, 8 were seen to have friction related skin injuries, two were actively dying, and six patients were too unstable for a complete skin evaluation, hence 66 patients were not included.
2. What are the advantages and disadvantages to the proposed recommendations in the article?
The Braden score, knowledge of the patient's disease process and comorbidities, and the use of appropriate tools and mechanisms like skin bundles to prevent skin injuries are all advantages of the proposed recommendation. On the other hand, the recommendation's disadvantage is the incorrect interpretation of the assessment of the skin, such as pressure ulcer versus friction burn
1) Discuss the sample size used in this study.
ReplyDeleteThe study was conduct In the Midwest. 354 patients were assessed from those patient only 8 patient qualified for this study, which were confirmed to have friction skin injury.
2) How dose this research article compare to our practice.
In this research data was collected during quarterly skin assessment, the patient's skin was assessed head to toe and data was collected. During this data collection they were able to identify patient with friction skin injury. PSJMC skin assessment is done every shift, on admission and discharge. The assessment is done the same way head to toe, and injury are identified if there is any. If there are skin injury wound consult is implemented and appropriate interventions are implemented.
What is the sample size used in the study?
ReplyDeleteThe sample size for this quality improvement project was an academic medical center with 728 licensed beds in the central plains of the United States. The survey assessment and data were collected from 354 patients.
How does this research article compare to our practice, policy and/or procedure?
Very similar approach is taking place at hour hospital to prevent skin issues and pressure ulcers. Part of morning assessment is to complete skin assessment every shift and appropriately document findings. Braden Scale is also a great tool to prevent skin breakdown. Appropriate interventions are always available in our hospital for patients who have low Braden score. Wound Care Nurses are also available to assist with recommendations to promote healing.
Discuss the sample size used in the study.
ReplyDeleteThe study was conducted in a large academic medical center in the Midwestern United States with 354 patients. There were 420 patients on the day of survey, but only 354 made it to be considered for the study. Nine of the 354 patients initially had a friction skin injury (FcI). Eight of the patients were later found to have FcI.
How does this research compare to our practice, policy and/or procedure?
The author points moisture as a problem in 62.5% of the patients with identified FcI. Of the 8 patients who were later found to have FcIs, a majority (5/8) had some type of incontinence. Every single one of the 8 patients had disposable absorptive bed pad during the assessments. At PSJMC, nurses perform skin assessments Qshift. By doing so, we can order wound care consultations for any suspected skin damage/injuries and provide wound care treatment per order. We put effort to prevent skin injuries from occurring whether it be placing preventive foams, elevating the heels using pillows or heel protectors, repositioning Q2H, etc. When it comes to incontinent patients, we provide frequent skin assessment and offer more cleaning to prevent FcIs. When either external or internal catheters are being used as a measure to prevent moisture damage, nurses and CNAs also pay close attention to the placement of the tubing to prevent further skin injuries.
Jung Eun Lee, RN.
1. Discuss the sample size used in the study.
ReplyDeleteThe study reports that data were collected on 354 patients from a large academic medical center in the Midwestern United States. There were 8 patients (2.3%) that were found to have friction skin injury. The majority were male patients, ages range from 57-91, skin injuries were located on one or both medial gluteal areas, majority of sample study (62.5%) had incontinence and multiple comorbidities.
2. Describe the research method used by the author of the study.
The article reports this study was a quality improvement (QI) project in a large academic medical center in the Midwestern United States. The hospital has 728 licensed beds and is a level 1 trauma center with Magnet designation achieved through the ANCC Magnet Recognition Program. The data was collected as part of the institution’s quarterly skin survey for the National Database of Nursing Quality Indicators (NDNQI) Pressure Ulcer Prevalence Survey (PUPS).
Discuss the sample size used in the study.
ReplyDeleteThe sample size of this study involved an academic center with 728 licensed beds in the central plains of the US. Data were collected by 33 clinicians: 28 were RN staff and 5 were patient care technicians. Prevalence data were collected on 354 hospitalized patients.
How does this research article compare to our practice, policy and/or procedure?
Prevention and care friction skin injuries is of utmost importance in the acute care setting as is directly influences quality of life and patient outcomes. It is crucial to assess for lichenification, soft tissue discoloration/deformation, callus formation, and skin ulceration in routine skin assessments. Furthermore, this study emphasizes the idea that the moisture produced in incontinent episodes poses a significant risk for breaks in the skin barrier and should be a priority to the healthcare team at all times.
Discuss the sample size used in the study.
ReplyDeleteFour hundred twenty patients were available for assessment on the day of the survey and data were collected on 354 (83.8%). The study took place in a 728-bed acute care level 1 trauma center in the Midwestern United States in August 2019.
Describe the method used by the author of the study.
The study was a quality improvement project performed in a large academic medical center in the Midwestern United States. During the survey completed in August 2019, 33 hospital-employed staff participated in data collection; 28 data collectors were RNs and 5 were patient care technicians (PCTs). Of the 28 RNs, 6 were board-certified wound nurses and 2 were in training but not yet certified. Data collection was used among the assessed patients which measured friction skin injury (Fcl) prevalence, locatio nof skin damage and lesion, color, and blanchable versus non-blanchable skin. Other items included were dry skin, pressure injuries, incontinence and use of absorbent pads, braden scale, past medical history, and mobility such as transfering and repositioning patients.
1.Discuss the sample size used in the study.
ReplyDeleteThe sample used on this study involve 728 licensed beds in the central plains of the United States.Data were collected by 33 clinicians: 28 were RN Staff members and 5 were certified. Prevalence data were collected on 354 hospitalized patients.
2. Describe the method used by the author of the study.
Friction skin injuries were measured in conjunction with the instituitions quarterly skin survey for the NDNQI PUPS (National Database of Nursing Quality Inidicators Pressure Ulcer Prevalence Survey ) in Aug 2019.The prevalence of Fcl was calculated using the number of patients with Fcl divided by the total number of patents surveyed.
FEBRUARY 2023 WOUND AND OSTOMY JOURNAL
ReplyDeletePrevalence of Friction Skin Injury on the Buttocks and/or Posterior Thighs in an Acute Care Setting
Describe the method used by the author of the study
This was an article of quality improvement
How does this research article compare to our practice, policy and/or procedure?
Data gathered compares to our practice at saint joseph medical center in that nurses performed quarterly wound care assessments. We also gather data and have quarterly meetings to discuss our statistics and how our current practice compares to the previous quarter along with the previous year.
-Valarie Renaux RN, ICU-
Discuss the sample size used in the study:
ReplyDeleteThis quality improvement project was conducted at a 728-bed hospital in Midwestern United States. This unidentified hospital is also a Level 1 trauma center with Magnet designation. There were four hundred twenty patients identified for this study, but data was only collected on 354 patients. Sixty-six patients were omitted from this study due to various reasons. Reasons for omission included: 33 declined participation, 2 were dying, 25 were not on the unit when the survey was conducted, and 6 were considered too unstable to move in order to conduct a full skin evaluation. In addition, this quality improvement project was considered exempt from requiring individual consent from the patients because the data was collected as part of the institution’s quarterly skin survey for the National Database of Nursing Quality Indicators (NDNQI).
Limitations of the article: Limited sample size.
The author of this quality improvement project claims that there has been scarce research on Friction Skin Injury (FcI). However, I am not convinced that this study in which she acted as the project lead, was conducted in a truly accurate manner. I suppose that I have two main concerns regarding this project. First, the staff that obtained the data. The author stated that the staff who collected the data were all hospital employees. And that 28 were RN’s and 5 were patient care technicians. And of the 28 RN’s, only 6 were board-certified wound nurses and 2 were in training but not yet certified. So that means that 33 individuals collected data but only 6 were board certified. Therefore, only 18% of the data collectors were fully trained in wound care and wound assessment. That makes me very suspicious of the accuracy of the data collection. My second concern is that assessing wounds is an inaccurate art. One individual may look at it subjectively and another may look at it objectively. I just don’t see an unequivocal way to assess wounds consistently and therefore accurately identify the etiology of the FcI and ways to mitigate future skin damage. Finally, I believe that the number of patients involved in this project was very small.
Discuss the sample size used in the study.
ReplyDeleteOut of 420 patient who were available for assessment, data was collected from 354 patients for this study in 2019. The patients were located in at a Midwestern medical center in United States. Of the 354 patients sampled, 8 were seen to have friction related skin injuries.
How does this research article compare to our practice?
The article discusses data gathered quarterly during the skin surveys for the NDNQI as it relates to skin friction injury (FcI). The PSJMC quarterly skin surveys are also conducted as indicated in the article; patients are assessed head to toe by a team of nurses as data is gathered and then submitted. We currently don’t have a quality improvement (QI) process in place specific to FcI as the article indicated that it was one of the first to be published as it relates to Fcl. I am sure that with further studies and proven benefits, the FcI will be another acronym to add to the RN vocabulary.
1. Describe the method used by the author of the study
ReplyDeleteData collection method among assessed patients used by the author to measure friction skin injury prevalence include demographic characteristics, location of skin damage /lesions, skin color and weather they are blanchable or non blanchable. Dry skin ,pressure injuries and other wounds near friction skin injury were also considered. Fecal and urinary incontinence, use of absorbent pads, Braden scale, past medical history, mobility prior to admission and device for transferring and repositioning were also included.
2. How does this research article compare to our practice, policy and/or procedure?
Data gathered compares to our practice at saint joseph medical center in that nurses performed quarterly wound care assessments. We also gather data and have quarterly meetings to discuss our statistics and how our current practice compares to the previous quarter along with the previous year.
1. Discuss the sample size used in the study
ReplyDeleteThe sample used in the study was at a large academic medical center in the Midwestern United States with magnet designation achieved through the ANCC Magnet Recognition Program. There were 728 licensed beds and 420 patients were available for assessment on the day of survey, however data was collected on 354 (83.8%) patients. There were 66 patients that were excluded (15.7%) because they either declined, were actively dying, off unit during time of survey, or too unstable to move for full skin assessment. A total of 8 patients were found to have friction related skin injuries.
2. Describe the method used by the author of the study.
The method used by the author of the study was a quality improvement project with 33 hospital- employed staff participants. The study used date from the quarterly NDNQI pressure ulcer prevalence study of August 2019. The prevalence of FcI was calculated using the number of patients with friction skin injuries divided by the total number of patients surveyed.
1. Discuss the sample size used in the study.
ReplyDeleteData from a prevalence study was collected and studied on 354 hospitalized patients from a 728 bed hospital. It is unknown how many beds in the hospital were occupied at the time of the study, but a group of 354 patients is a considerably large amount to assess for the prevalence of friction skin injuries.
2. How does this research article compare to our practice, policy, and/or procedure? Friction skin injuries could be found in any inpatient hospital setting. Our hospital also takes part in the NDNQI quarterly prevalence studies.
1. Discuss the sample size used in the study.
ReplyDeleteThe sample size used in this study was undertaken in a large medical center in the midwestern US with 728 licensed beds and 420 patients were available for assessment on the day of survey and data were collected on 354 patients. Friction-related skin injuries were discovered in eight patients , yielding a prevalence rate of 2.3%.
2. Describe the method used by the author of the study.
The method used is a qualitative method. Data collected were demographic characteristics, location of the skin damage/lesions, and skin color/changes noting whether lesion were blanchable or unblanchable.
1. Discuss the Sample size used in the study
ReplyDeleteDuring the day of the survey there were 420 patients available for the skin assessment. From the 420 patients, data was collected from 354 patients which constituted the 83.8% of the patients. From the 420 patients, 66 were excluded from the study which is 15.7%. From the 354 patients, 9 were initially identified as having a friction skin injury. However, after the survey 8 were confirmed to have friction skin injury which constitutes 2.3%.
2. Describe the method used by the author of the study.
Quality data collection was used in order to gather information on friction skin injury. As a part of the survey, patient information such as age, sex, number of days the patient has been at the hospital was identified. Additionally, in the quality data method the anatomical location of the friction skin injury was noted, as well as the clinical manifestations such as characteristics, color, tissue deformation, and ulceration. Continence and activity/mobility were also important assessment characteristics.
Discuss the sample size used in the study.
ReplyDeleteWithin a large 728 bed hospital, prevalence data was collected on 354 patients out of the 420 patients that were available for assessment the day that the survey was collected. 66 patients were ultimately excluded from the study. 33 out of the 66 patients declined to participate, 25 patients were off unit at the time of the study, 2 patients were actively dying, and 6 were too unstable to participate. Out of the 354 patients, 8 of them were confirmed as having a friction skin injury.
Describe the method used by the author of the study
The method used by the author of the study was data collection and outcome analysis with the goal of quality improvement on friction skin injuries. This was initiated in a large academic medical center in the Midwest United States.
Discuss the sample size used in the study.
ReplyDeleteThe sample size used during this study took place in a large academic medical center in Midwestern, USA where 354 patients were included during the study. As a result of this study, “8 of the 354 patients” were found with friction injuries. A rate of 2.3% of prevalence study was evident during a quarterly study with 728 acute beds. In conclusion, 354 of data collected presented with 66 excluded patients, 33 patients refusing to participate, 25 patients missing on the unit during this study, 2 actively dying, and 6 unstable to participate. The outcome showed nine of the 354 surveyed patients had friction skin injury.
How does this research article compare to our practice, policy and/or procedure?
The article discussed about the use of Braden Scale for Pressure ulcer scoring during this study. Upon admission, the article elaborates on data collecting to determine “Fcls were facility acquired or present on admissions.” Photographs were also obtained to help identify Fcl and documented on EMR. I believe this is consistent with our current practice at PSJMC as these are vital tasks a registered nurse completes upon patient admissions.
Describe the method used by the author of the study
ReplyDeleteWas the correct method used? Why or why not?
The method used in this study was data collection and outcome analysis. The data collection included demographic characteristics such as, location of skin damage, skin color and changes that noted blanchable or unblanchable. As for the outcome analysis, prevalence was calculated as the number of patients surveyed divided by the number of patients with friction skin injuries.
I do believe the methods used were correct. Providing all information created a quality improvement project that determined prevalence of friction skin injuries in acute care.
Discuss the sample size used in the study.
In a hospital with 728 licensed beds, data was collect from 354 patients out of a total of 420 patients that were available for the assessment, making the sample 83.8% studied. Of the 420 patients, 66 were excluded giving a 15.7% exclusion. Friction skin injuries were identified on 8 of the 354 patients providing a prevalence rate of 2.3%.
Discuss the sample size in the study.
ReplyDeleteThe study was performed across an academic medical center with 728 hospital beds in the central plains of the United States. Data was collected on 354 hospitalized patients by 28 RN staff members and 5 patient care technicians, eight of which had friction related skin injuries.
How does this research article compare to our practice and policy?
This research article is similar to our practice and policy of preventing skin injuries. As mentioned in the article, the Braden scale is used to assess patients and determine their need to be turned Q2H based on their score. We assess skin at east every shift to check for any changes and consult the wound care nurse when needed.
Was the correct method used? Why or why not?
ReplyDeleteThe fact that this was a quality improvement project, I say the correct method was used. The project was undertaken in a large academic medical center in the Midwest. The data sheet was made to collect data for skin prevalence and included things like demographic skin characteristics, location of skin damage or lesions, blanching or not, and moister of the skin as well.
How does this research article compare to our practice, policy and/or procedure?
This research correlates well with how we practice at our hospital. We have data sheets and programs for skin prevalence particularly. Our policies in place help to manage and prevent pressure injuries from occurring as well as prevalence of many other skin conditions. We have implemented the use of devices and equipment to help protect against shearing and also helps decrease the amount of force needed to move or reposition patients. We also have implemented the use of skin barriers to decrease the amount of incontinence related skin damage as well as adhesive related skin damage.
How does this research article compare to our practice, policy and/or procedure?
ReplyDeleteWe assess patient’s skin every shift, sometimes every multiple times in a 12 hour shift at PSJMC. Our policy is to reduce friction caused injuries; we also follow our Braden Scores and implement preventative measures based on these scores to prevent skin related injuries – such as turning every two hours, keeping their skin clean and dry especially if they are incontinent and immobile. We also do skin prevalence studies at our acute care facility.
Discuss the sample size used in the study.
This qualitative study was collected on 354 patients in an academic medical center with 728 licensed beds in the United States. It was collected by 33 hospital-employed staff members; the sample size initially appeared to vary due to the availability of the participating patients. However 9 of the 354 patients seen had FCL
ReplyDelete1. How does this research article compare to our practice, policy and/or procedure?
It compares to our practice because at PSJMC we have quarterly skin surveys that are also conducted. We also assess skin every shift with the Braden scores and turn patients every two hours.
2. Discuss the sample size in the study?
The study was conducted on 728 licensed beds in the central plains of the United States. The data was collected by 33 clinicians 28 of those were RN's and 5 were patient care technicians.