Article: The Prevalence of Skin Tears in an Acute Care Hospital
Year Published: November 2024
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Describe the method used by the author of the study:
ReplyDeleteThe main purpose and method of this quality improvement project was to determine the prevalence of skin tears within a large, urban hospital in the Midwest. The patients were identified as having skin tears during quarterly NDNQI assessment surveys over the course of 4 quarters. Data examined for each skin tear included the location of the tear, risk factors observed from that patient, and classification of the skin tear using the Payne-Martin Classification System. When a skin tear was identified during NDNQI rounding by trained Skin Care Champions, a data collection form was utilized to gather the additional information required for analysis.
Discuss the sample size used in the study:
The setting for this QI project was a 676 bed urban teaching hospital in the Midwest which has Magnet designation. All adults, children, and neonates were assessed during the data collection period (4 quarters), but the team chose to exclude the mother/baby unit as well as patients who were unsafe to move, actively dying, off the unit during the survey time, and those patients who refused a skin assessment by the Skin Care Champions. This QI project cited a study in Singapore which examined the skin tear prevalence on 2 units, as well as a study in Cina which looked at skin tear prevalence within a 9-hospital system, and finally a single hospital in Denmark with a single data collection survey over the course of three days. Because this is a quality improvement project for this particular team of 4 WOCN nurses, utilizing four quarters of data in the large facility could very well be sufficient for their purposes of determining their own facility's skin tear prevalence across their wide array of patient populations (age and patient demographics in an urban area). The sample can help guide these wound care nurses towards the goal of collecting information to guide interventions in the future to reduce the incidents of skin tears.
Research Question: The purpose of the study was to determine the prevalence of skin tears within an acute care hospital. The study leaders defined a skin tear as a traumatic wound that is the result of friction and/or shearing forces that separate the epidermis from the dermis. They note that depending on the depth of the tissue injury the skin tear can be classified as a partial- or full-thickness wound. Skin tears are thought to be a common injury that is underreported, overlooked and frequently results in delayed or inadequate management. Those with skin tears report it to be very painful and have a negative impact on their quality of life. The purpose of this QI project was to determine organizational prevalence of STs using the revised Payne- Martin classification system. Specifically, data were collected relevant to the location, risk factors and classification of the STs.
ReplyDeleteSample size: This quality improvement project was set in a 676- bed Midwestern urban teaching hospital with Magnet designation in the US. Those included in the study were all adults, children and neonatal patient, excluding those on the mother-baby floor and patients who were unsafe to move (13 patients), actively dying (8 patients), off unit during survey assessment (39 patients) or who declined to participate (66 patients). The data collection occurred quarterly over the span of 4 quarters. A total of 1576 patients were assessed for skin tears, approximately 383-409 per quarter. Forty-six of the assessed patients were found to have skin tears, while 13 patients were found to have multiple tears, totaling 69 skin tears found.
Describe the main problem in the study.
ReplyDeleteSkin tears although common finding in acute care settings are frequently overlooked and underreported by health care providers. Skin tears can affect all types of patients and may have negative impact in their quality of lives.The purpose of the QI project was to determine the prevalence of skin tears within an acute care hospital. The study showed that the prevalence was highest among geriatric- psychiatric followed by critical care units. The most frequent ST sites ate upper and lower extremities.The most frequent risk factors are frail skin advance, advanced age and impaired mobility.
What are the advantages of implementing the article recommendations on your unit or hospital?
In the unit where I work, most of our patients are elderly with decreased mobility , agitated behavior, cognitive impairment and frail skin.These are some of the factors that are associated with the occurrence of skin tears. We do weekly wound photo to assess pressure ulcers and SWAT team does pressure ulcer prevalence monthly but not much emphasis on skin tear prevalence.Skin tears are sometimes overlooked and underreported. Skin tear can be painful, increase risk of infection and delay wound healing. We should also focused on risk assessment and prevention strategies to decrease the incidence of painful skin tears. Early consultation to wound care RN and implementing proper wound care should also be done.
Describe the method used by the author of the study:
ReplyDeleteThe method used were collected concurrently with the quarterly Pressure Injury Prevalence Survey over a period of 12 months (beginning the third quarter of 2017 through the second quarter of 2018) by the Pressure Injury Prevalence Survey Skin Care Champions using the revised Payne -Martin classification system for STs. A data collection form developed by the Wound ,Ostomy and Continence nurse was also completed for the patients with ST(s)
Discuss the sample size used in the study:
ReplyDeleteThe sample size of the study was in the setting of 676 bed Midwestern Urban teaching hospital with Magnet Designation in the United States.All Adult, children and neonatal patients were assessed during the data collection period with the exclusion of the mother baby unit and patients who were unsafe to move ,actively dying of the unit during the survey assessment ,or those who declined participation.The Determining of the exact sample size for a study on skin tear prevalence in an acute care setting depends on several factors ,including the desired level of precision, the expected prevalence , and the characteristics of the population being studied
Bethany Sobesto 6/23/25
ReplyDeleteDescribe the method used by the author of the study
The nurses identified skin tears during the quarterly pressure injury prevalence skin check days. This was done at a midwestern urban teaching hospital. It was done quarterly for a year, which was a total of 4 days of data collection. They used a data collection form and then transferred the information into an Excel, 2016 version 16 program. The prevalence of skin tears is the total number of patients with a skin tear divided by the total number of patients assessed. Excel was used to do this calculation.
Discuss the sample size used in the article
Over the course of a year there were 1576 patients assessed at a midwestern urban teaching hospital which had 676 beds. Patients in the mother baby unit were excluded and patients who were unsafe to move were also excluded from the study. Of the patients assessed, 46 of them had skin tears. 21 of these 46 patients were women and 25 were men.
1. Describe the method used by the author of the study
ReplyDeleteThe researchers carried out a one-year quality improvement project at a 676-bed urban teaching hospital to determine how often skin tears (STs) occurred among patients. Instead of starting a new study from scratch, they combined their data collection with the hospital’s existing quarterly Pressure Injury Prevalence Survey (PIPS). This made the process more efficient and ensured that already-available resources and staff could be used.
To collect the data accurately, nurses called Skin Care Champions, received special training from a wound care specialist. They learned how to recognize and classify skin tears using the revised Payne-Martin system. These nurses worked in pairs to assess patients in adult, pediatric, and neonatal units. Patients in the mother/baby unit or those who were too ill or unavailable were not included.
When a skin tear was found, the nurses filled out a form that included the patient’s age, sex, wound location, and possible causes. Over the four quarters of data collection, the information was entered into Excel, and descriptive statistics were used to analyze how common skin tears were and what trends were present.
2. Discuss the research question or main problem discussed in the study
The main problem this study focused on was the lack of clear data on how common skin tears are in acute care hospitals. Skin tears are injuries caused by friction or shearing forces that can be painful and are often missed by healthcare providers. The research question aimed to find out the prevalence of these injuries in one hospital and to understand the common risk factors involved.
The authors wanted to raise awareness about skin tears because they are frequently overlooked, even though they negatively affect patients’ comfort and safety. By identifying how many patients had skin tears, where the injuries usually happened, and what factors made people more likely to have them, the researchers hoped to help hospitals create better prevention strategies in the future.
April 2025
ReplyDeleteDiscuss the sample size used in the study.
The sample size for this study was based on a 676-bed hospital located in the Midwest. The hospital is a Magnet designated hospital that contained units including: adults, children and neonates. The population selected included all units except Mother/baby, pts who were unsafe to move due to acute illness, those actively dying, patients unavailable at the time of survey and those who actively declined to be involved in the study. A total of 1,576 patients were included in this research study.
Discuss the limitations of the article: limited sample size, design flaws, and/or author bias.
Several limitations of the research study were found after analysis of all the data. It was found that the hospital had a much lower occurrence of skin tears within the population due to the inclusion of pediatric and neonate participants. This lowered the occurrence of skin tears compared to previous research findings. It was also found that participation was cut short due to the development of the covid pandemic, results in the inability to continue quarterly research and patient participation in the study. It would be interesting to have determined skin tear prevalence during this time of a pandemic due to limits in staff, isolation status and acute illness of the patients.
1. Discuss the sample size used in the study?
ReplyDeleteThe sample size includes all adults, children and neonatal patients during the data collection except the mother/baby unit and patients who were unsafe to move, actively dying, off the unit during the survey or those who declined participation.
The sample size used were from a 676 bed Midwestern Urban teaching Hospital with Magnet designation in the United States. The data collected occurred quarterly over the span of 4 quarters.
Categories used in the sample size included hospital unit, patients age, sex, community acquired vs. hospital acquired setting, location, risk factors and classification of ST's.
2. Describe the method used by the author?
ST (skin tear) prevalence data were collected with the Quarterly Pressure Injury Prevalence Survey over a period of 12 months and by the Pressure Injury Prevalence Survey Skin Care Champions using the revised Payne-Martin classification System for ST's.
Trained Skin Care Champions attended an educational program on assessment and classification of ST's. The education was 1 hour, covering the definition of ST's, risk factors, prevention of ST's and how to used the revised Payne-Martin classification system for ST's.
The Payne-Martin Classification System for skin tears were used to classify the degree of wounding when a skin tear occurs. The System consists of 3 skin tears categories and 5 skin tear types based on the characteristic of the epidermal injury.
What are the advantages and disadvantages of implementing the article recommendations on your unit and/or hospital?
ReplyDeleteImplementing these recommendations could strengthen our skin injury prevention program by standardizing assessment and identifying high-risk patients before injuries occur. This could significantly reduce the amount of skin tear incidences in our patients. However, it would require more staff training and ongoing competency checks, which could be challenging in units with high workloads.
Describe the method used by the author of the study.
This was a year-long quality improvement project conducted in a 676-bed urban teaching hospital, embedded within the hospital’s quarterly National Database of Nursing Quality Indicators Pressure Injury Prevalence Survey. All patients except those in the mother/baby unit and those meeting specific exclusion criteria were assessed. Skin Care Champions, trained in skin tear identification and classification using the revised Payne-Martin system, performed assessments in pairs. Data were recorded on a standardized form, capturing demographic details, Skin tear classification, location, acquisition type, and risk factors, and were analyzed descriptively using Excel.
Discuss the sample size used in the study.
ReplyDeleteThe sample size used in the study was 1,576 patients. This sample included adults, children, and neonates from various inpatient units in a 676-bed Midwestern urban teaching hospital with Magnet designation in the United States. Some patients were excluded in the study. These are patients who were unsafe to move, actively dying, off the unit during the survey assessment, those who declined participation and the mother/baby unit. Forty-six (2.92%) of the 1576 patients assessed were found to have skin tears. The sample size was sufficient to identify patterns in skin tear occurrences in this study.
Discuss the limitations of the article: limited sample size, design flaws, and/or author bias.
Although this study has a large sample size, the study was conducted in a single hospital over four quarterly data collection periods. Another limitation is that there is no comparison data collected regarding skin tears on patients who did not have a tear, therefore, patient characteristics could not be compared. Lastly, neonates and pediatric patients have lower risks of developing skin tears. The result may be affected and limit the conclusion for the high risk elderly group population.
Discuss sample size
ReplyDeleteThe setting of this project was a 676 bef Midwester urban teaching hospital with Magnet designation in the US. All adult, children, and neonatal patients were assessed during the data collection with exclusion of the mother and baby unit, patient who were unsafe to move, actively dying, or those who declined participation. The data collection ocurred over a period of 12 months. 21 patients were women, 25 were men, with age avarage of 69.9 years old.
2) Describe the method used by the author of the study.
Data were collected concurrent with the quarterly pressure injury prevalence survey over a period of 12 months by the pressure injury prevalence survey skin care champions using the revisef Payne-Martin classification system for st. Data collection form developed by the Wound, ostomy, and continence nurse was also completed.
1) How does this research article compare to our practice, policy and/or procedure?
ReplyDeleteAlthough I agree that skin tears are common occurring in our ICU and can be missed by health care providers, we have cought pretty good the episodes of skin tears applying a dressing from my experience so far. It was easy to understand their findings such as STs prevalence in Critical care units was about twice high compared to other floors and the most common site of STs were on the extremities because I also observed STs on the extremities in common in my ICU. In my opinion, STs in the extremities can be treated easily and well most of the time. However, opened woulds due to ruptured blisters in the perineal/inner thighs are challenging to treat and difficult to heal. Thank goodness, we have good WOCNs to consult not only for pressure ulcers, but also for challenging STs.
2) What are the advantages and disadvantages of implementing the article recommendations of your unit and/or hospital?
The advantages are empowering nurses by education, which results in prevention of STs and can contribute enhancing Patient’s QOL. We are more empowered for recognizing and treating STs by 1 hour- education (definition of STs, risk factors, prevention of STs and how to assess systematically) like this article conducted. Since we already have skin team educating annually by WOCNs, it must be easy to provide the education. If we can conduct the research to find STs prevalence in our hospital, we would know our tendency and where to focus precisely like this article presented.
Disadvantage would be cost since the current situation even limit the nurses to take an annual class by WOCNs for Skin team.
Discuss the sample size used in the study ?
ReplyDeleteThis was a quality improvement study which does not require to have patient consent. The study was done at 676 bed Midwestern hospital with Magnet designation. The data was collected over a span of four quarters during which skin was assessed by a Skin Champion Nurse in the unit. Adults, children and neonates were all part of the study except mother baby unit. Also, those patients who were actively dying, off unit or declined participation did not include as part of the study.
How does this research article compare to our policy , procedure and practice.
This article is very similar to hour hospital policy and practice as well. Our hospital also has Magnet designation and we also perform quality improvement practices to prevent skin breakdown. Once a month we have wound prevalence days. 3-4 nurses assess all patient's wounds and make sure all preventative measures are taken into consideration. This assessment allows us identify high risk patient's and to make sure they do not develop further skin breakdown. Documentation get completed and reviewed by Wound Care Team and Management.
This comment has been removed by the author.
ReplyDeleteDescribe the method used by the author of the study.
DeleteThis is an Observational Study Design, assessing a defined population at a particular time to identify the prevalence of skin tears and associated factors. A point prevalence survey was used and data were collected concurrently with the quarterly Pressure Injury Prevalence Survey over a 12- month period.
The approach was a quality improvement project aimed to provide an accurate assessment of skin tear prevalence in an acute care hospital setting using standardized and comprehensive patient inclusion criteria, excluding only those who were unavailable or unsuitable for assessment. The prevalence of skin tears was calculated and details recorded about location, category (using revised Payne- Martin Classification), and risk factors such as frail skin, advanced age, and impaired mobility. The revised Payne-Martin classification system was used to categorize skin tears into three main categories based on the extent of skin loss. This classification helps in assessing the severity of skin tears and extent of skin flap loss.
Discuss the sample size used in the study.
The sample size of 1,576 patients for this prevalence study is reasonable within the context of a quality improvement project in this hospital. The sample size is enough to provide valuable baseline data and highlights the prevalence of skin tears in the setting, which can drive future interventions and resource allocation within the hospital. However, this study used a form of convenience sampling where all eligible patients in the hospital during the data collection periods were assessed. This approach effectively created a census of availability rather than sampling a small targeted subgroup. Convenience sampling may lack representativeness of the broader patient population because the sample consists only of patients available and accessible during the survey times (excluding those off unit, unsafe to move, or who declined). There is potential for sampling bias. The sample may overrepresent certain patient groups who were easier to assess, potentially skewing the prevalence results. At the same time, important cases might be missed if patients were unavailable or excluded, leading to an underestimation or overestimation of skin tear prevalence.
Despite this issue, convenience sampling can be practical and efficient in clinical settings where comprehensive random sampling is challenging for quality improvement initiatives.
Discuss sample size.
ReplyDeleteThe data collection occurred over the span of four quarters. The study was done in the Midwest Urban teaching hospital with magnet designation in the US. The hospital had 676 beds. The patients that were selected were children, neonatal patients, adults, except mother and baby unit, also patients that were unsafe to move and actively dying, or patients that declined participation. Total of 1,576 patients were included in this study.
Described the method used.
The data was collected over a period of 12 months, nurses called skin care champions that attended educational classes to teach them how to assess and classify the skin tears were used. The skin care champions were using the revised Payne-Martin classification system for skin tears. The data collection form developed by wound, ostomy and continence nurses was also completed. Depend on how deep the injury was, skin tears can be classified as partial or full thickness. The skin care champions were working in pairs and assessing patients. Over the four quarters they collected data, and statistics were used as well to analyze the data.
Discuss the research question or main problem discussed in the study?
ReplyDeleteThe main problem discussed in this study is the under reporting of skin tears that results in delayed or inadequate management of the skin tears. This is a quality improvement project that was done to determine the prevalence of skin tears in the acute care setting. Data collection showed the units with higher skin tear prevalence and found that the inpatient geriatric-psychiatric unit had approximately four times more likely to have skin tears. It was also found that the major risk factors contributing to skin tears were advanced age and impaired mobility. This information identified high risk populations and provided interventions such as moisturizing dry skin and implementing the use of protective dressings.
How does this research article compare to our practice, policy and/or procedure?
There are many risk factors that make patients more susceptible to skin tears, some of the risk factors that were mentioned include dehydration, poor nutrition, impaired mobility, and mechanical factors. As a bedside nurse, we play a crucial role in the assessment and treatment of skin tears and overall skin health on our patients. The article describes providing training to “skin care champions” which are members of the unit to help with skin tear assessment and classification. This is similar to our ministry’s practice of skin checks and documentation done on wound Wednesday and rounding done by members of the skin surveillance team. We also implement preventive measures to take extra care of a patient that is high risk for skin tears such as the moisturizing of patient’s skin and placing protective foam dressings.
Hermine Tsaturyan
ReplyDelete1. Discuss the research question or main problem discussed in the study?
The main problem discussed in this article is to identify what quality improvement projects can be completed in order to prevent the occurrence of skin tears within an acute care hospital. The study concentrates more specifically on older and more frail patients. The study also concentrated on the risk factors that may increase the chances of the skin care which some of the highest ones include frail skin, advanced age, impaired mobility, fall, cognitive impairment, etc. From the study it was identified that most skin tears tend to occur in the upper and lower extremities.
2. Discuss the sample size used in the study.
The total number of assessed patients included 1,576 patients cross a 12-month period. There were about 46 cases of skin tears identified. The age distribution of the skin tears were found in all age groups; however, the mean age was about 70 years of age. As discussed above, most of the skin tears were on the bilateral upper and lower extremities, and 65% of the skin tears were hospital-acquired. There were about 39 patients who were excluded out of the study due to being off the unit, 66 patients refused assessment, and 13 were unsafe to be assessed at the time of the study.
Discuss the research question or main problem of the study:
ReplyDeleteSkin tears in acute care settings are overlooked by healthcare providers involving all age groups. Most skin tears (ST) during the prevalence were found on the extremities and are mostly hospital acquired. The prevalence utilized the revised quality improvement classification to identify major risk factors that included patients impaired mobility, frail skin, and advanced age. The study focused on the risk factor assessments and prevention to reduce the risk of skin tears utilizing the revised method of Payne-martin Classification.
Discuss the sample size in the study:
The sample size involved a 676 bed Midwestern Urban teaching hospital with Magnet designation. It involved adults, children, and neonatal patents excluding mother/baby, actively dying patients, patients who were unsafe to move, off unit during assessment, and those who declined participation. A total of 1576 patients were assessed for skin tear (383-409 patients per quarter). The prevalence data were collected over a period of 12 months beginning third quarter of 2017 thru second quarter of 2018. WOC, CNS, and Trained Skin Champions participated during the study utilizing the revised classification of Payne-Martin Classification.
1. What are the advantages and disadvantages to the proposed recommendations in the article?
ReplyDeleteThe article recommends developing protocols, staff education, and prevention strategies for skin tears. The advantages are that prevention programs could help nurses recognize risks earlier, reduce hospital-acquired injuries, and improve patient comfort and safety. Standardized protocols would also improve consistency in care and documentation. These steps could lower costs linked to wound treatment and shorten recovery times. The disadvantages are that creating and implementing education programs requires time, staffing, and financial resources. In addition, competing priorities, like the COVID-19 pandemic, can delay or prevent programs from being put into practice.
2. Describe the method used by the author of the study.
This was a quality improvement project conducted in a 676-bed Midwestern teaching hospital. Data were collected during four quarterly Pressure Injury Prevalence Surveys between 2017 and 2018. All eligible patients were assessed, except those who were unsafe to move, actively dying, off the unit, or who declined. Trained “Skin Care Champions” nurses, educated in the Payne-Martin classification system, performed the assessments. They worked in pairs to increase accuracy and completed a test for reliability. Data on patient demographics, location of tears, risk factors, and classification were recorded and analyzed with descriptive statistics. Prevalence was calculated by dividing the number of patients with skin tears by the total number assessed.
Discuss the research question or main problem discussed in the study?
ReplyDeleteSkin tears are frequently found in acute care settings; they occur in all age groups and are unnoticed by health care providers. This study aimed to assess how common skin tears are among patients in an acute care setting. Bedside nurses play a pivotal role in identifying skin tears, preventing them, and deploying the treatment for these tears.
How does this research article compare to our practice, policy and/or procedure?
At Saint Joseph’s we have nurses who are skin champions and part of SWAT, similarly to this study. In the research study trained skin care champions attended a training session similarly to what our SWAT nurses do. They also round in every unit to assess for skin integrity. In the study when a skin tear was identified, data was collected. Our nurses will report any untreated wound, to assure patient is getting treatment.
1. Discuss the research question or main problem discussed in the study
ReplyDeleteThe main problem that is discussed in this study is that skin tears are a common finding in the acute care setting across all age groups and are frequently overlooked by healthcare providers. Skin tears are injuries that are caused by friction or shearing forces. Risk factors for skin tears include the age-related skin changes, dehydration, poor mobility, poor nutrition and medication therapy. This project provides a clear strategy on how to determine the skin tear prevalence in the health care setting. The study utilized the revised Payne-Martin classification system for skin tears to categorize and document skin tears of patients in the acute care setting. This study provides information to guide interventions to reduce skin tears.
2. Discuss the limitations of the article: limited sample size, design flaws, and/or author bias
One flaw of this study is that it was only conducted at a single hospital, therefore it is hard to generalize the findings. Limited resources also meant that statistical analysis was not performed. Another limitation of the study was that the only preexisting conditions that were reviewed was from the original history and physical. The history and physical could have left out certain pre existing conditions or risk factors. Additionally, a large amount of the participants were pediatrics and neonates which skin is inherently less likely to break down.
1. Discuss the research question or main problem discussed in the study.
DeleteThe purpose of this study was to examine the amount of skin tears in the hospital. There is a lack of reporting skin tears for patients who are hospitalized. The study was conducted in order to understand common risk factors and interventions to prevent skin tears. Skin tears are wounds that occur when the skin experiences shearing or friction. Skin tears are painful and have a negative impact on the patient. This quality improvement project examined skin tears over the span of four quarters and data was collected concerning the skin tears location, risk factor and classification of the skin tear. The study found that skin tears were more prevalent on the patients extremities and that the biggest risk factor to skin tears were fragile skin, advanced age and being dependent on care from caregivers.
1. DIscuss the sample size used in the study:
ReplyDeleteThis study assessed skin tears from a total of 1576 patients, or 383-409 patients per quarter for a year, from a 676-bed Midwestern urban hospital with Magnet designation. Adults, children and neonatal patients were assessed with the exclusion the mother/baby unit, patients unsafe to move based on their health status, those actively dying, off the unit and those who declined participation. 7 additional patients were not included due to incomplete or missing documentation.
2. Discuss the research question or main problem discussed in the study:
Skin tears (ST) are common injuries in the hospital setting, a traumatic wound thought to be underreported, overlooked, and can result in delayed or inadequate treatment. Despite preliminary studies in hospitals internationally, there is still limited data regarding ST in the acute care setting. Specifically, this study is part of a quality improvement project that seeks to determine the prevalence of STs in an acute care hospital in the Midwest using the Payne-Martin classification system. Patients are assessed during quarterly National Database of Nursing Quality Indicators Pressure Injury Prevalence Surveys over the course of one year.
Alyssa Mendoza
ReplyDeleteDescribe the method used by the author of the study
A quality improvement prevalence survey approach was utilized in this study. The study was done in a 676 - bed midwestern urban teaching hospital with magnet designation in the United States. All adult, child, and neonatal patients were assessed during the survey periods, except those in the mother/baby unit or who were unsafe to move, actively dying, off the unit, or who declined participation. The Skin tear data was collected quarterly over a span of 12 months at the same time as the hospitals Pressure Injury Prevalence Survey. Skin care champions who underwent training and participate in classes from each unit performed the surveys. Any identified skin tear was classified using the revised Payne-Martin classification system. Then data including hospital unit, patient age/sex, location, risk factors, and classification of ST was collected. Findings included 46 of 1,576 had at least one skin tear, majority were on upper/lower extremities, men more prevalent than women, most were hospital-acquired and the highest prevalence occurred in geriatric-psychiatric unit.
What are the advantages and disadvantages of implementing the article recommendations on your unit and/or hospital?
I believe that implementing Skin tear (ST) data collection to our hospital would be beneficial in many ways. Incorporating ST data collection during the existing Skin Prevalence Studies each month would save time and resources and allows staff to improve early identification and classification in skin tears enabling sooner interventions. This can increase awareness of problem areas and support prevention efforts. There aren’t many disadvantages to implementing this to our hospital except shortages in member participation, which increases time, effort and funding.
1. Discuss the research question or main problem discussed in the study?
ReplyDeleteSkin tear is a traumatic wound where the outer layers of the skin, typically the epidermis and dermis, separate due to mechanical forces like friction, shear or blunt trauma. ST can be classified as a partial or full thickness wound.
In the acute care setting, STs are very common injury that is underreported, overlooked and most likely results in delayed or inadequate management.
Risk factors identified in this study are age-related skin changes, dehydration, poor nutrition, sensory changes, impaired mobility, medication therapy and mechanical factors impacting skin.
Despite identifying the risk factors and studies on STs, there is still limited study concerning ST in acute care setting.
2. How does this research article compare to our practice, policy and/or procedure?
During this study, the hospital employed one Wound, Ostomy and Continence CNS and inpatient wound service consisting four nurses- two are certified in wound and ostomy care.
Compared to our Hospital, PSJ have a " team skin champions"- composed of WOC certified nurses and bedside nurses. We have SWAT Team who meets at least every month to prevalence skin study. Every Wednesday we have weekly skin check on all patients. PSJ have skin bundles or protocols to guide each nurses with skin issues not just ST's.
1. What are the advantages and disadvantages to the proposed recommendations in the article?
ReplyDeleteThe authors recommend implementing targeted prevention strategies based on identified risk factors such as frail skin, advanced age, and impaired mobility. The advantages of these recommendations include using evidence-based practices to reduce skin tears, tailoring interventions to vulnerable patients, and potentially improving patient outcomes while lowering healthcare costs. However, there are also disadvantages, including the need for significant resources to train staff and perform regular assessments, variability in staff adherence, limited generalizability since the study was conducted in a single hospital, and the possibility of underreporting skin tears, which could affect the effectiveness of prevention efforts. Overall, while the recommendations provide a helpful framework, their success depends on careful implementation and consistent staff participation.
2. Discuss the sample size used in the study.
The sample size consisted of 1,576 patients admitted to a 676-bed urban teaching hospital. Among these patients, 46 individuals (2.92%) were found to have skin tears, with most of these injuries occurring on the extremities and being hospital-acquired. This sample size allowed the researchers to estimate the prevalence of skin tears within the hospital population and identify key risk factors such as frail skin, advanced age, and impaired mobility. While the sample was adequate for observing trends in this specific hospital, the findings may not be fully generalizable to other hospital settings with different patient populations or resources.
1. How does this research article compare to our practice, policy and/or procedure?
ReplyDeletePressure ulcer prevention is a common focus on hospital units to decrease the incidence of hospital acquired pressure injuries and to prevent the worsening of community acquired pressure injuries. These policies are followed hospital-wide and the nurses at PSJMC are educated and trained to assess skin and wounds and to place wound care consults when necessary. However, the study focuses on skin tear prevalence within the acute care setting. Skin tears can occur during a patient's stay at PSJMC, especially if there are multiple risk factors such as age-related skin changes, poor nutrition, or impaired mobility; however, the nurses on the units are trained to treat and consult the wound care nurses so that appropriate treatment can be ordered as part of the hospital's policy.
2. Discuss the sample size used in the study.
The study was conducted in a 676-bed Midwestern urban teaching hospital that is Magnet recognized with varying patient population of adult, children, and neonatal. At this location, data was gathered on 1576 patients. The respective numbers on the units are the following: critical care, 117, step-down, 422, med/surg, 662, inpatient rehab, 116, pediatric ICU, 25, pediatric, 61, RNICU, 122, inpatient geri-psych, 51.
1. Describe the research method used by the author of the study.
ReplyDeleteThe authors utilized a quantitative improvement project design over 4 quarters (1 year) to identify and document skin tears at a urban hospital with Magnet designation. The study provided education and utilized the Payne-Martin classification for skin tears. Risk factors were identified when an skin tear was found. This methodology allowed for direct observation rather than depending on chart reviews, than could be inaccurate.
2. Discuss the limitations.
Some limitations that were discussed include – the single acute hospital that conducted the study. This limits the generalizability of results to other settings with different policy/practice or patient populations. A second weakness was that there was no comparison data collected when skin tears found against a patient that did not have a skin tear. So patient characteristics were not assessed.
Discuss the research question or main problem discussed in the study?
ReplyDeleteThe article discusses the prevalence of skin tears within an acute care setting. It defined a skin tear as a traumatic wound, often overlooked, caused by friction that separates the epidermis from the dermis. It addressed important risk factors that include age, poor nutrition, dehydration, medication therapy, and inadequate or poor mobility. They collected data that shower critical care and geriatric psychiatric units had the most prevalence of skin tears particularly in the upper and lower extremities.
How does this research article compare to our policy , procedure and practice.
As a Magnet designated hospital, like the one mentioned in the article, we are held to higher levels of patient care. At Providence St Joseph, we have implemented the SWAT team which are trained nurses that round to address and evaluate pressure injuries and ensure appropriate preventative measures are in place. Furthermore, the article addresses the crucial role all bedside nurses play in properly identifying, preventing, and managing skin tears as part of our holistic care of the patient. By reducing and addressing the risk of skin tears or pressure injuries, we are ensuring a better quality of life for the patient.
David Kahn RN 5s
ReplyDeleteDiscuss the research question or main problem discussed in the study?
Skin tears are under reported and potentially undertreated due to lack of reporting. Skin tears can be painful and can take a long time to heal if not treated appropriately. The purpose of the study was to determine how prevelnt skin tears are in that particular hospital.
Discuss the sample size used in the study.
sample size was a data review at a 676 bed hospital. 1576 total patients were reviewed. 46 patients had skin tears. This number of incidents represented 2.92% prevalency
Discuss the limitations of the article: limited sample size, design flaws, and/or author bias.
Limitations of this study were that it was difficult to compare what is a good prevalency number for skin tears due to the fact that it is usually underreported. there needs to be more data collected by more facilities to determine a better benchmark or standard for incidence numbers. The limited data from other facilities that this study was able to find does seem to suggest that the 2.9% is better than other hospitals that had >6%.
Discuss the sample size used on the study.
ReplyDeleteThe study use a sample size of 1,576 patients. The patients used were adults, children and neonates from various inpatient units in a 676 bed midwestern urban teaching hospital in the united state. Some patients that were excluded for the study were unstable patients (13), actively dying or on comfort care (8), off the unit (39) and patient who decline to participate on the study (66). 7 patients were excluded due to missing/incomplete documentation. Out of the 1,576 only 46 about 2.92 percent of the study had skin tears occurrences.
How does this research compare to our policy, procedure and practice.
Most of our population are geriatric and bed bound. Our facility has been working on creating ways to prevent this patients from getting skin breakdown. We have a team of nurse that meet once at month called the swat team, they are trained nurses that round on patient already admitting to the hospital and assess/identified patients on high risk of developing skin breakdown. Skin tears are some one common on this patient due to their age and health status.
1. Discuss the sample size used in the study?
ReplyDeleteThe setting of this project was a 676 bed Midwestern urban teaching hospital with Magnet designation in the US. All adult, children, and neonatal patients were assessed during the data collection with exclusion of the mother and baby unit, patient who were unsafe to move, actively dying, or those who declined participation. The data collection occurred over a period of 12 months. 21 patients were women, 25 were men, with an age average of 69.9 years old.
2.Discuss the research question or main problem discussed in the study?
The main problem discussed in this study is the under reporting of skin tears that results in delayed or inadequate management of the skin tears. This is a quality improvement project that was done to determine the prevalence of skin tears in the acute care setting. Data collection showed the units with higher skin tear prevalence and found that the inpatient geriatric-psychiatric unit had approximately four times more likely to have skin tears. It was also found that the major risk factors contributing to skin tears were advanced age and impaired mobility. This information identified high risk populations and provided interventions such as moisturizing dry skin and implementing the use of protective dressings.
Discuss the research question or main problem discussed in the study?
ReplyDeleteThe main problem discussed in this study was to conduct a quality improvement project to determine skin tear prevalence in an acute care hospital. The main purpose of this study is to shine light on skin tears because they are often overlooked and under reported because they are seen as a common injury. I believe they are overlooked compared to PU, but do have a negative impact on the patient’s quality of life.
Discuss the sample size used in the study.
The sample size used in this study was taken from a Midwestern urban hospital with 676 beds and Magnet designation. This study included adults, children, and neonates. The sample size excluded the 42 bed mother/baby unit and patients who were unsafe to move, actively dying, or off unit.
1. 1. Discuss the research question or main problem discussed in the study
ReplyDeleteThe main problem discussed in this study is to determined the prevalence of skin tears within the acute care hospital. Skin tears in the acute care settings are often missed/overlooked by health care providers; and this includes all age group. Skin tear can be very painful and can cause a negative impact of their quality of life.
2. Discuss the sample size used in the study?
The sample size that is being used in this study are taken from a Midwestern Urban Hospital with 676 beds and Magnet designation. The sample size does not include the 42 bed which is the mother and baby unit and patients who were unsafe to move. This study include neonates, children, and also adults patients; excluding mother and baby unit. Skin tear data is collected quarterly over the span of 4 quarters during the National Database of Nursing Qualities Indicators. The patients skin will be assess by the Skin Care Champions on each unit.
1. Discuss the research question proposed in the study.
ReplyDeleteThe research question in this study was to determine the prevalence of skin tears within an acute care hospital. This is a relevant topic within the hospital setting as skin tears are a common injury that is underreported, very painful, and have a negative impact on quality of life. The researchers used the revised Payne-Martin classification system for skin tears to help classify and identify these wounds.
2. Discuss the limitations of the article.
One limitation noted in this article is that the data was collected from a single facility so the findings cannot be generalized. A robust statistical analysis could not be performed due to limited resources. In the context of the COVID-19 pandemic, suspension of all protocols and education in development of projects occurred so that the ST reduction program did not move to implementation. This means that they could not do further studies to see if their implementation would be effective.
Mary Becerra BSN, RN, CHPN
Describe the method used by the author of the study.
ReplyDeleteFor the study, data was gathered from a Midwestern teaching hospital that has a total of 676 beds. All of the eligible participants were evaluated, excluding those who actively died, declined participation, or were unsafe to move. Trained nurses, who were referred to as "Skin Care Champion" nurses, carried out the assessments. They used the Payne-Martin system to measure various aspects of the patients' demographics and tear locations. The data collected during the study were then analyzed using statistical methods. The prevalence of skin tears was calculated by taking into account the number of patients who were evaluated.
Discuss the sample size used in the study?
For the study, the nurses evaluated 1,576 patients over a year. They then analyzed another 383 to 409 individuals every quarter. The hospital where the study was conducted had a total of 676 beds, and it was a Magnet teaching facility. The study participants included various types of patients, including adults, children, and newborn babies. Exclusion criteria included the mothers and babies unit, as well as patients who were dying, declined to participate, or were deemed too unsafe to move.
How does this research article compare to our practice, policy, and/or procedure?
ReplyDelete- This article covers the risk factors associated with developing skin tears in the acute care setting such as dehydration, nutrition, age, and immobility. In our current practice, we encounter many patients that have one, if not more, risk factors present. In these types cases, there immediate nursing interventions that we can do such as using appropriate off-loading devices and frequent turnings. We also have at our disposal the use our interprofessional team, such as getting a dietitian involved to make suggestions that help maintain skin integrity.
Discuss the research question or main problem discussed in the study?
- This study aimed to identify the prevalence of skin tears within the acute care setting. The study used a modified Payne-Martin Classification System for Skin Tears to better organize and identify the skin tears that occur in the hospital. Prior to this classification system, the skin tear prevalence was unknown to the organization. With the help of using the modified classification system, the organization was able to identify that skin tear prevalence was 2.9%, which is lower compared to other studies
Felli Gaddi Ruiz
ReplyDeleteDiscuss the research question proposed in the study.
The prevalence of skin tears within an acute care hospital is the main research question at hand for this study. This topic is highly relevant due to the prevalence of such injuries, its general lack of reporting, highly painful nature of the pathology, and adverse affects on the patient’s quality of life. The revised Payne-Martin classification system was used by the researchers to help the characterization of these wounds.
Discuss the limitations of the article.
The single facility gathering site of the data reduces the generalizability of the information, thus is a main limiting factor of this article. Also, the limited resources of the experiment further reduces the ability of a strong statistical analysis to be performed. Another limitation of the article is that the COVID-19 pandemic forced the suspension of all protocols and education in that period of time, thus preventing further studies to analyze it’s implementation
1. Describe the method used by the author of the study.
ReplyDeleteThe authors utilized a quality improvement framework to investigate the prevalence of skin tears within a 676-bed acute care hospital. Data collection occurred quarterly over twelve months, concurrently with the National Database of Nursing Quality Indicators Pressure Injury Prevalence Survey, and was conducted by trained Skin Care Champions who assessed patients using the revised Payne-Martin classification system for skin tears. The study population included all adult, pediatric, and neonatal patients, with exclusions applied to the mother/baby unit, patients deemed unsafe to move, those actively dying, patients absent during the assessment, and individuals who declined participation. Information regarding skin tears, including anatomical location, associated risk factors, and classification, was systematically documented on standardized forms and subjected to descriptive statistical analysis in Excel to determine prevalence rates, percentages, and mean patient age.
2. Discuss the sample size used in the study.
The study encompassed a total sample of 1,576 patients, with data collected over the course of one year through four consecutive quarterly assessments. The sample included adult, pediatric, and neonatal patients, thereby providing a comprehensive representation of the hospital population. Exclusion criteria were applied to patients in the mother/baby unit, those deemed unsafe to move, actively dying, absent during the survey, or those who declined participation, in addition to a small number with incomplete documentation. This substantial sample size enabled the researchers to accurately assess the prevalence of skin tears across diverse patient populations and hospital units.
Describe the method used by the author of the study
ReplyDeleteThe method used is the data collection during the National Database of National Database of Nursing Quality Indicators PIPS survey by trained skin champions on assessments and classifications of skin tears educated by WOC nurse on identification of ST's, risk factors, prevention of ST's, and how to use the Payne-Martin classification system for ST's. The setting for this study was a 676 bed hospital. All adult, children and neonatal patients were assessed with the exclusion of the mother baby unit, patients who are unsafe to move, actively dying, patients who were off the unit during the survey and those who declined consent for participation.
How does this research article compare to our practice, policy and/or procedure?
ReplyDeleteComparing to our practice at our facility, we really don't have a program in place that surveys the prevalence of skin tears. We mostly look at the prevalence of pressure injuries instead. Reporting, documentation and treatment are being done but prevalence is probably not being tracked.
Also, there is not enough education on the importance of preventing, detecting risk factors for skin tear occurrence, and proper treatment at our hospital.
Discuss the sample size used in the study:
ReplyDeleteThe sample size of the study included 1,576 patients, which included neonates through adults. The study was done over the course of one year out of one urban teaching hospital located in the Midwest U.S. The study included six different units from geriatric psychiatric, critical care, med/surg, step-down, neonatal ICU, pediatric, and rehab.
Discuss the limitations of the article:
Some of the limitations of this study included the use of only one hospital for data, and lack of risk factor analysis. Within the study itself, there was also no comparison or control group of patients without skin tears to provide further information. Out of all the data collected from patients, only 46 patients had skin tears leading to only a small amount of data to be collected from that particular group. Within the data collected there was also unequal data collected from different patient populations/units.
Describe the main problem in the study.
ReplyDeleteIn the article, skin tears is common finding in acute care settings and are frequently overlooked and underreported by health care providers. Skin tears can affect all types of patients and may have negative impact in their quality of lives.The purpose of the QI project was to determine the prevalence of skin tears within an acute care setting hospital. The study showed that the prevalence was highest among geriatric followed by critical care units. The most frequent affect sites are upper and lower extremities.The most frequent risk factors are frail skin advance, incontinent, advanced age and impaired mobility.
Discuss the limitations of the article.
The single facility gathering site of the data reduces the generalize of the outcome, thus is a main limiting factor of this article. Also, the limited resources of the experiment reduces the ability of a strong statistical analysis to be performed. Another limitation of the article is that the COVID-19 pandemic forced the suspension of all protocols and education in that period of time, thus preventing further studies to analyze it’s implementation
Describe the main problem in the study
ReplyDeleteSkin tears are common in hospitals, but they are often missed or not reported by healthcare staff. They can happen to any patient and may lower quality of life. The purpose of this project was to find out how often skin tears occur in a hospital setting. The study showed they were most common in geriatric-psychiatric patients, followed by those in critical care. Skin tears mostly happened on the arms and legs. The biggest risk factors were fragile skin, older age, and limited mobility.
What are the advantages of implementing the article recommendations on your unit or hospital?
In my unit, many patients are older, have poor mobility, fragile skin, agitation, or cognitive issues—factors that increase the risk of skin tears. While we do regular photo checks for pressure ulcers and monthly assessments with the SWAT team, skin tears are not given as much attention and are often underreported. Skin tears can cause pain, infection, and slow healing. By focusing more on risk assessments and prevention, we could lower the number of skin tears. Early referrals to wound care nurses and proper wound care would also improve patient outcomes.