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.