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For documents located in SharePoint Site (CA SJ Wound and Ostomy) look for the article and click it to open. April 2026 - Assessing Knowledge among Endoscopy Nurses. Don't forget to write your name with each posting.
-The endoscopy department of 427 bed suburban community hospital served as a setting for the evidence- based skin tear prevention quality improvement project. Patients in endoscopy may originate from out patient ,inpatient, emergency room or ICU.The inclusion criteria for the study included registered nurses working with adult patients in endoscopy who had completed at least two of the three STPQIs (Skin Tear Prevention Intervention Questionnaire ) Nursing experience averaged 14.7 years for theses endoscopy nurses.
Describe the method used by the author of the study
- A multidisciplinary approach was implemented to create an endoscopic specific STPP Skin Tear Prevention Protocol, including review of current literature and collaboration with wound care nurse, physical therapists and endoscopy staff. Appropriate prevention measures identified for endoscopy included staff education on best practice, identification of at risk patients, and using a skin tear prevention bundle. For 12 weeks of study, a paper copy of the STRAT ( skin tear risk assessment tool) was placed in patient’s medical chart.If patient was identified at risk , the nurse initiated appropriate STPP ( skin tear prevention protocol).It was then communicated between admitting and procedural nurse.The procedural nurse is responsible for continuing the STPP.The procedural nurse then communicated the risk assessment to recovery nurse who then continued the STPP. The admitting, procedural and recovery nurse are all responsible for verifying that documentation has been completed and that any new skin tear have been appropriately reported.
Research Question: Between spring and summer of 2022, a noticeable increase in skin tears was identified in the endoscopy department of a 427-bed suburban community hospital in Scottsdale, AZ. The goal of this evidence-based quality improvement project and feasibility study with a pre/post-timed series survey design had three main goals: to design and implement an evidence-based skin tear prevention protocol for endoscopy, evaluate this protocol for usability and effectiveness, and assess endoscopy nurse's skin tear prevention knowledge. A literature review revealed that no studies on skin tear incidents or prevention in the endoscopy setting could be found leaving the question related to best practices for skin tear prevention in endoscopy unanswered. A multidisciplinary team approach was needed. One survey revealed a concerning lack of knowledge among nurses regarding skin tear risk assessment, prevention and treatment regardless of their educational background and experience. A systematic review found that implementing a skin tear bundle, regardless of the individual components, leads to decreased skin tear incidence, and early identification of at-risk patients is key. Additional studies regarding safe patient handling to prevent tears from friction and sheering, the use of limb coverings and best practice adhesive removal strategies in settings other than that of endoscopy were reviewed.
Methods: A feasibility study with a pre/post-timed series survey design was developed and conducted over three months to assess nursing knowledge and the effectiveness of the STPP on skin tear prevention. The authors developed a Skin Tear Prevention Intervention Questionnaire (STPIQ) in collaboration with wound care nurses. A scoring tool was utilized to evaluate the STPIQ content for validity and reliability, and questionnaire was then utilized with endoscopy nurses at baseline, one month and three months. A PowerPoint presentation summarizing skin tear prevention measures specific to the endoscopy setting was provided to staff via work emails, presented at staff meetings and discussed in walking rounds. The Skin Tear Risk Assessment Tool (STRAT) was adapted for the endoscopy setting and was completed on all patients ages 65 or older upon admission and included a list of skin tear risk factors, suggested interventions based on the risk assessment, and a reminder to complete all documentation. The admitting, procedural, and recovery nurses were all responsible for completing the STRAT and implementing the appropriate STPP interventions. The endoscopy nurses implemented 911 skin tear prevention interventions and there was a 66% reduction in skin tears over the three months of the study.
How does this research article compare to our practice, policy, and procedure? In this article the staff took a multifaceted approach that included teaching, assessing patients for risk factors, and skin tear prevention protocol implementation. In our practice I feel that although during our assessment we identify patients at risk for shearing and skin tear injuries, that all to often we rush and do not implement proper prevention such as proper lifting equipment or using adhesive remover even though these tools are readily available. I feel that with more education and reinforcement of policies and procedures the hospital as a whole might be able to cut down on skin tear injuries, much like was done in this study.
What are the advantages and disadvantages to the proposed recommendations in the article? The advantages to the proposed recommendations in the article would be to reduce the number of skin tears suffered during the hospital stay. This would greatly improve patient satisfaction and outcomes and also reduce costs in extra resources, time, diagnostics, and treatment and law suits that may arise from skin tears that arise from improper care. The disadvantages of the recommendations proposed in this article is the extra cost of educating the staff and the time it would take to implement even more policy and procedure into an already cramped schedule. Overall I believe the benefits outweigh the costs of implementing the recommendations of the skin tear prevention interventions.
April article: Assessing Knowledge Among Endoscopy Nurses With Implementation of a Skin Tear Prevention Intervention
Question #1: Discuss the sample size used in the study.
The endoscopy department of a 427-bed suburban community hospital in Scottsdale, AZ, served as the setting for this evidence-based skin tear prevention quality improvement project. Endoscopy is a fast-paced and vibrant patient care area that serves high and low- acuity patients of all ages. Patients in endoscopy could have originated as outpatients, inpatients, from the emergency room, or the ICU. The inclusion criteria for the study involved registered nurses working with adult patients in endoscopy who had completed at least two of the three STPQIs (Skin Tear Prevention Intervention Questionnaire ). Nursing experience averaged was 14.7 years for theses endoscopy nurses.
Question #2: What are the advantages and disadvantages to the proposed recommendations in the article?
The article proposed Skin Tear Prevention Protocol Design. The proposal included on educating staff on best practices, identifying at-risk patients, and using a skin tear prevention bundle that includes skin preparation wipes, stockinette limb coverings, safe patient handling techniques, and adhesive remover wipes. The form of education included a power point presentation summarizing the skin tear prevention measures to endoscopy setting, printed educational materials, rounds discussion.
Skin Tear Prevention Bundle included applying skin prep before using adhesives, using adhesive remover wipes, for all tape and dressing removal, placing stockinette sleeves on the upper extremities if proning or turning the patient, and employing proper techniques while moving and repositioning patients.
I see these proposals as more advantageous not just in the endoscopy settings but wherever & whenever it is necessary, especially while a patient is hospitalized. The advantages can comprise of providing better if not excellent care to patients, improve nursing skills competence, lesser number of hospitalizations days related to complications, etc.
What I see as a disadvantage is the cost. Although it is projected as less than $ 2 per patient with cumulative cost, it will an additional expenditure.
March article: Leaving Slings and Other Transfer Devices Under Patients: A Clinical Decision Support Quality Improvement Project
Question # 1: Discuss the research question or main problem discussed in the study?
The article's evidence suggested that sling and transfer device use is a cause of hospital-acquired pressure injuries, and therefore skin protection must be considered when using these devices. The Veterans Health Administration facilities utilize fabric slings with safe patient handling and mobility equipment for patient transfers. Knowledge or best practice regarding the safety of leaving slings under patients' skin has not been established. To address this evidence gap, the Veterans Integrated Services Network (VISN) Patient Safety Center of Inquiry (PSCI) conducted a quality improvement project to develop guidance regarding leaving slings and other transfer devices under patients and potential for skin or pressure injury risk. The purpose of this report is to describe current use of slings and transfer devices at VHA facilities and introduce a guidance document that may be used to facilitate best practices in use of transfer equipment
Question #2: Describe the method used by the author of the study
Quality improvement project activities were conducted from October 2019 to September 2021 using a mixed-methods rapid assessment approach. The objectives were to collect data about common practices at VHA facilities related to leaving slings under patients, examine reported patient transfer practices and associations with rates of inpatient pressure injuries, and evaluate current practices against best available evidence to develop guidance about safely using slings to reduce pressure injury and skin injury risk. The data collection techniques were cross-sectional surveys, electronic health record review, and qualitative interviews. This project was determined to be quality improvement (QI) by the James A. Haley Veterans’ Hospital Research and Development Committee and therefore exempt from additional Institutional Review Board. The feedback on practices and perceptions related to leaving slings and other transfer devices was evaluated using online cross-sectional surveys and interviews with VHA staff. Secondary data for VHA inpatient rates of pressure injury were used to examine associations with staff-reported sling and other transfer device practices.
February article: Intensive Care and Operating Room Nurses’ Knowledge Regarding Skin Tears
Question #1 Discuss the research question or main problem discussed in the study?
Skin tears are common injuries, especially in hospital-based settings such as intensive care and operating rooms. These injuries usually occur as a result of skin vulnerability and incorrect use of medical devices. Nurses have an important role in the prevention, early detection and management of skin tears. Previous research has shown that nurses' knowledge of skin tears varies and is sometimes inadequate. There are a limited number of studies comparing the knowledge levels of operating room and intensive care nurses. The questions that were addressed in this study were the level of knowledge of operating room and intensive care nurses regarding skin tear and the factors that are affecting their level of knowledge.
Question #2: Discuss the limitations of the article: limited sample size, design flaws, and/or author bias
This study has several limitations which should be taken into consideration when interpreting the findings. The sample of the study was limited to nurses in a specific institution, and the generalizability of the results to the entire population of nurses is limited. Data were collected through self-report, and nurses' preventive interventions for skin tears and the accuracy of their implementation could not be assessed through direct observation. Therefore, additional research is recommended to determine the factors that prevent the dissemination of accurate knowledge and practices and the underlying causes of these factors.
January article: Predictors of Patient Participation in Pressure Injury Prevention: An Observational Sub study
Question #1 Discuss the sample size used in the study
The parent trial inclusion criteria were adults admitted in the previous 36h to medical and surgical units of three large metropolitan hospitals, whose expected hospital length of stay was greater than 24h and who were at high risk for a pressure injury. In the state where the study took place, hospitals used the Water low scale as a risk assessment tool. Therefore, patients at risk of pressure injury were defined as either a Water low score of ≥10 or patients who had limited mobility. Patients were excluded if they were unable to be turned, had an existing sacral pressure injury or other lesion in the sacral area at the time they were recruited, had urinary or fecal incontinence , or were unable to speak or understand English if no interpreter was present. When individuals are incontinent, the dressing manufacturer recommends a different process for dressing application, which introduces a difference in the way the dressings are applied within the intervention group. Therefore, the parent trial excluded patients with Incontinence. All participants in the parent trial were included in this analysis. A power analysis showed that with eight predictors, a sample size of 766 would have >95% power to detect a small effect (0.03) with an alpha of p<0.05 [27]. This sample size also allows us to assess the scale's psychometric properties
Question #2 Discuss the limitations of the article: limited sample size, design flaws, and/or author bias
This study has several strengths, including its large, adequately Powered sample, providing confidence in the study's results. They also used an instrument that had previously been shown to be valid and reliable. While most fit statistics were met in their study, and were similar to those previously reported for this scale, two were not. However, given the chi-square is sensitive to large samples, this was not unexpected. Additionally, room mean square error of approximation values of 0.05 to 0.08 are generally considered acceptable, with values 0.0.08–0.1 marginally acceptable, thus some use the criteria of <0.10 [29, 36] which was met in their study. Thus, we conclude the PPPIP scale is valid and reliable. This research also has some limitations. First, because participants were part of a larger clinical trial with strict inclusion and exclusion criteria, the findings may not be generalizable to patients not at pressure injury risk, not incontinent, or not in a pressure injury study. Second, they did not have data on patients' current health status. They used the number of comorbidities as a proxy for health status, but recognize the two are not the same. Third, we they not measure actual PIP behavior; patient participation was self-reported. Finally, their model predicted a very small amount of variance in scale scores.
Bethany Sobesto 5/16/26 Discuss the limitations of the article: limited sample size, design flaws, and/or author bias The sample size was small and they only included patients in the GI endoscopy area. More studies need to be done to see if is feasible to do the skin tear risk assessments on other floors in the hospital. Also, the number of skin tears reported relied on nurses reporting of them. This self reporting may not have been accurate or reliable since some nurses are not honest about the number of skin tears they assess or they are too busy to do a thorough assessment of the patients. What are the advantages and disadvantages to the proposed recommendations in the article? The advantages would be a decrease in the number of skin tears in patients and potentially a higher patient patient satisfaction score. As more nurses are educated on how to prevent skin tears, they can do things such as use adhesive remover when removing a dressing, use no sting barrier to protect skin before applying an IV tegaderm dressing, and be careful not to quickly/aggressively rip off tape from the patient's skin. A disadvantage is the time it takes to educate nurses on skin tear prevention and the increase in cost associated with having to use extra supplies. Although, the increase in cost was only $2 per patient in this research study, so I believe the increase in cost is worth it to help protect the patient's skin.
Discuss the sample size used in the study A feasibility study was used to measure nursing knowledge on skin tear prevention in endoscopy and nurse satisfaction with the skin tear prevention protocol .A pre/post survey was used to measure nursing knowledge at baseline ,one month ,and three months post protocol implementation.Over the three month study 537 endoscopy patients >65 years old were identified to be at risk for skin tears .Endoscopy nurses implemented 911 skin tear prevention nursing interventions.This project demonstrated an 88% gain in nursing knowledge and a 66% skin tear reduction in endoscopy .The findings provide an optimistic outlook for skin tear prevention in endoscopy settings . For assessing endoscopy nurses during new protocol or checklist implementations ,a sample size of 60-120 participants (or about 30 to 60 per group )is typical for experiment or pilot studies Endoscopy patients >65 years old who often present with the risk factor for skin tears ,e.g advanced age ,chronic health issues ,limited mobility, and compromised integumentary ,were the focus of a skin tear prevention intervention .This evidence -based quality improvement project and feasibility study with a pre/post timed series survey design had three main goals to design and implement an evidence based skin tear prevention protocol for endoscopy ,evaluate this protocol for usability and effectiveness and assess endoscopy nurses skin tear prevention knowledge .
What are the advantages and disadvantages to the proposed recommendations in the article? Implementing a skin tear prevention and management protocol in an endoscopy setting offers significant clinical and operational benefits ,primarily by reducing patient and injury ,but requires navigating some practical challenges like additional staff documentation .Advantages such as Fewer Injuries and less pain by utilizing risk assessment tools and safety equipment
.Cost Efficiency by preventing tears translates directly to lower material usage ,shorter patient turnaround times and reduced health care cost
..Improved knowledge and Satisfaction by education initiatives yields substantial gains in nursing confidence, enabling staff to handle acute wounds quickly and effectively.Better Patient Experience by avoiding traumatic wounds protects patient dignity and satisfaction
While the Disadvantages are as follows Increased initial workload by admitting and procedural nurses must take the time to complete risk assessments and communicate per patient skin tear risk
Documentation Burden by which nurses face the added task or detailed clinical documentation -classifying the wound and recording the exact cause and treatment pathway
Learning curve by which adapting to modern wound management techniques
Fast Paced Constraints wherein taking time to precisely reapproximate tiny ,fragile skin flaps can be challenging during busy quick turn around lists .
Discuss the sample size used in the study. The research study focused on a specific endoscopy department in a 427 bed hospital located in Scottsdale, AZ. IN 2022, this specific endoscopy center saw 8,203 patients. Inclusion criteria for study focused on nursing knowledge and feasibility study included RNs working with adult patients who have completed 2 or 3 STPIQs. Education and experience levels were also evaluated for the nurses raging from diploma to MSN degrees. the average years of experience for the nurses was 14.7 years.
Discuss the research question or main problem discussed in the study? The research article examines best practice strategies to reduce skin tears of patients within the endoscopy setting. It was found that in the spring and summer at a specific center that there was a notable increase in skin tears. There was no specific risk assessment or protocol prevention in place to help the population, especially those in older adults. The study found findings from the literature, and provided opportunities for skin tear prevention strategies.
Discuss the research question or main problem discussed in the study?
The main problem addressed in this study was a significant and unexplained increase in skin tears identified within an endoscopy department during the spring and summer of 2022. It's critical to highlight that the department lacked any standardized risk assessment tool or prevention policy at the time, leaving a vulnerable population of older adults at higher risk for injury. The research sought to determine if the implementation of an evidence based skin tear prevention policy could effectively reduce these incidents while simultaneously improving the knowledge of endoscopy nurses. This problem is particularly relevant because skin tears in procedural settings like endoscopy are often underreported and under researched, making it difficult to establish best practices for this specific clinical environment. By focusing on patients aged 65 and older who possess risk factors like fragile skin and polypharmacy, the study aimed to prove that these injuries are not inevitable but are preventable with the appropriate interventions.
Discuss the limitations of the article: limited sample size, design flaws, and/or author bias.
One of the biggest limitations of this research is the small and localized sample size, as the study was conducted within a single endoscopy department at one community hospital. This narrow focus limits our ability to generalize the findings to other units or larger hospitals. A potential design flaw exists in the study’s reliance on self reporting for the occurrence of skin tears. This creates an unreliable measure of success because nurses might not report injuries if they think the process as punitive or they may feel as if they're too busy to perform a thorough skin assessment during a busy shift. Additionally, because participation was voluntary the researchers acknowledged that the data might not capture the full range of knowledge or experience within the department.
April 2026 Discuss the sample size used in the study. The sample size of this study was in the endoscopy department located at a community hospital in Scottsdale, Arizona. Patient that are seen in the endoscopy department range from low acuity to high acuity and are all ages. Patients could come from out-patient, in-patient, the emergency department, or the ICU. This made the endoscopy department a great place to serve as the setting got the skin tear prevention QI project since they saw 8,203 patients in 2022 and 4,361 of those patients were aged 65 or older. The inclusion criteria for this study included nurses who work with adult’s patient in endoscopy who have completed at least two of the three Skin Tear Prevention Intervention Questionnaire. The nurses who participated had the following characteristics: 55% had a BSN, 13.5% had an MSN, 13.5% had an AND, and 17% diploma nurses. The average experience level for the endoscopy nurses was on average 14.7 years.
Discuss the research question or main problem discussed in the study. As people age, their skin becomes increasingly thin and fragile, therefore patients who are 65 years or older they are at an increased risk for skin tears. Therefore, while providing care to the aging population, more precautions should be utilized to prevent skin tears and preserve skin integrity. This article looks to better understand the prevalence of skin tears and prevention of skin tears in the endoscopy setting. The findings from the study served as the framework for developing skin tear prevention protocols specifically for patients who are in the endoscopy setting. The writers of this article were not able to find any studies that focus primarily on the incident or prevention of skin tears in the endoscopy setting. The study actually led to positive results to all three of the study aims. There was an increase in knowledge of endoscopy skin tear prevention, an overall agreement among the endoscopy nurses that the prevention protocol increases patient safety, and there was an overall reduction in skin years over a 12-week period.
The sample size for this study was 4,361 patients, with the criteria being endoscopy patients at a suburban community hospital who were also over the age of 65 years of age. These patients were a mixture of outpatient, inpatient, ER, and ICU patients. The other key part of this study was the nursing knowledge piece. Registered nurses in the endoscopy department completed at least two of the three skin tear prevention intervention questionnaire. Nursing experience was calculated at an average of 14.7 years for the endoscopy nurses who cared for the sample patients.
What are the advantages and disadvantages to the proposed recommendations in the article?
During the study, there was a 66% reduction in skin tears. There was also reported to be an 88% increase in nursing knowledge on skin tear prevention. The cost of the skin tear prevention bundle was estimated to be less than $2.00 per patient (skin prep wipes, adhesive remover wipes, and stockinette sleeves). With the increase in safety, better patient outcomes, and reduction of skin tears, it is very clear that the advantages outweigh the cost related to the bundle. In addition, nurses report that their nursing autonomy in initiating care bundles is linked with improved job satisfaction as well as nurse retention.
Describe the method used by the author of the study. The study used an evidenced-based quality improvement project and feasibility-study methodology, employing a pre and post timed series survey design. It was not a randomized controlled trial. The study supports observing improvement over time but without randomization or a control group. The team used a multidisciplinary process to develop the protocol and measured the nurses' knowledge with surveys at baseline, one month, and three months after the implementation. They also assessed the protocol's usability, effectiveness, and nurses' satisfaction.
Discuss the main problem discussed in the study. It evaluated an endoscopy-specific skin tear prevention protocol for patients aged 65 years and older suggesting that a structured, setting-specific prevention protocol paired with nurse education can improve staff knowledge and reduce this avoidable injury. It is in the premise of the study that older endoscopy patients may be susceptible to skin tears because of factors such as frail skin, presence of chronic conditions, reduced mobility, and impaired skin barrier state compromising its integrity from the use of different kinds of adhesives- which is inherent in all units, as a matter of fact.
1) Discuss the research question or main problem discussed in the study? The main problem discussed in the study was the high risk of skin tears among older adults receiving care in the endoscopy department. The researchers wanted to determine whether an evidence-based Skin Tear Prevention Protocol (STPP) could improve nurses’ knowledge and reduce skin tears. The study also evaluated whether the Skin Tear Risk Assessment Tool (STRAT) was useful for identifying patients at risk and guiding prevention interventions. After implementation, nursing knowledge increased by 88% and skin tears decreased by 66%, suggesting that the protocol was effective in improving patient safety.
2) Discuss the limitations of the article: limited sample size, design flaws, and/or author bias The study had a small sample size, with only 22 nurses participating and 17 included in the final knowledge analysis, which limits the ability to generalize the findings. The pre/post study design did not include a control group, making it difficult to determine whether the reduction in skin tears was caused specifically by the intervention. Skin-tear reporting depended on staff self-reporting, which could have resulted in underreporting or biased results. Additionally, the authors developed their own questionnaire and were involved in implementing the intervention, which may introduce measurement and researcher bias and affect the reliability of the findings.
1. Describe the method used by the author of the study.
The study applied a multidisciplinary approach with the main goal of decreasing the incidence of skin tears in patients 65 years old or older in an endoscopy setting. The first step was to create a feasibility study with a pre- and post-intervention survey through the development and utilization of a Skin Tear Prevention Intervention Questionnaire. This tool was tested for validity and reliability through a subset of peri-anesthesia nurses, and once that was established was then brought to endoscopy nurses for a baseline survey, at one month and then at three months post-intervention to assess any changes in skin tear knowledge. Concurrently with the 3-month survey, nurses were also given the RN Opinion of Effectiveness Questionnaire to assess the feasibility of the skin tear prevention protocol (STPP).
2. Discuss the limitations of the article: limited sample size, design flaws, and/or author bias.
The authors discuss the limits of a small sample size including both patients and nurses and the need to gather more data in order to substantiate their findings. Another limitation is the specificity of using just the endoscopy unit and whether this protocol can effectively be used in other patient care units. In addition, participation in the study was voluntary and may not reflect the knowledge of all of the nurses nor the more accurate percentage of improvement in knowledge. Answers were also self-reported and may reflect answers guided out of fear of punitive measures versus honest answers that reflect the true scope of the issues and how to improve them.
1. Describe the method used by the author of the study. A series survey design was utilized as the method used. It was conducted over a three month period to assess nursing knowledge and the effectiveness of the skin tear prevention protocol (STPP) on skin tear prevention. The authors conducted the survey with the Skin Tear Prevention Intervention Questionnaire that they developed in collaboration with wound care nurses. A scoring tool was used to evaluate the questionnaire for validity and reliability. The findings were used for three different aims including developing an STPP protocol for the endoscopy setting, evaluating its effectiveness and use and measuring nursing knowledge regarding skin tear prevention.
2. Discuss the sample size used in the study. The sample size used in this study included registered nurses working with adult patients in endoscopy. The education level of the nurses were mixed with 55% BSN, 13.5% MSN, 13.5% ADN and 18% diploma. Nursing experience averaged 14.7 years. These nurses worked in the endoscopy department of a 427 bed community hospital in Scottsdale, Arizona.
Discuss the research question or main problem discussed in the study? Skin tears occur, but there is increased risk for skin tears in older patients due to the decrease in collagen productions resulting in less elasticity and thinning of the skin. This study is looking at adults that are 65 years old and older that are having an endoscopy procedure. As the study points out, many skin tears heal on their own with minimal intervention, however there is a risk of the skin tear developing into a bigger/chronic wound. There was an increase in skin tears from spring and summer of 2022 identified in endoscopy patients. Therefore, skin tear preventions were implemented in the endoscopy care setting, skin tear prevention consisted of providing education to the nurses and the implementation of a skin tear bundle. The article then identified that by providing education to the nurses on risk assessment to identify high risk patients and use of the skin tear bundle, the incidence of skin tears in the endoscopy setting decreased by 66%.
Discuss the sample size used in the study. The setting used for this study was the endoscopy department of a hospital in Scottsdale Arizona. The study conducted was an evidence-based study that went on for three months, the number of patients cared for in the endoscopy department were 8,203, with 4,361 of those patients being 65 or older. The study’s aim was to assess the knowledge among endoscopy nurses, the education level of the endoscopy nurses were 55% BSN, 13.5% MSN, 13.5% ABD, and 18% diploma, with the average years of nursing experience being 14.7yr. The survey conducted showed an 88% increase in nursing knowledge.
Discuss the research question or main problem discussed in the study? Endoscopy setting had a notable increase in skin tears, the department had no specific protocol for skin tear risk assessment or prevention in place which prompted the staff to identify best practices of skin tear prevention. The study address three main goal: to implement evidence-based skin tear prevention for endoscopy patients, evaluate protocol for effectiveness and assess nurse’s skin tear prevention knowledge. Education on skin tear prevention was disseminated via email and staff meetings and printed materials. To identify at-risk patients Skin Tear Risk Assessment Tool (STRAT) was included upon admission and to be completed on patients over 65 year old. If the pt was identified at risk for skin tear, skin tear prevention protocol was implemented which involves using appropriate intervention for such as using skin prep wipes before placing adhesives and using adhesive remover wipes. applying sleeves to upper extremities. These implementation resulted to 66% reduction in skin tears over the three month period and increase in nursing knowledge.
How does this research article compare to our practice, policy and procedure? In this study they used skin tear tool assessment tool to assess patients over 65 for patients. In inpatient setting, skin assessment is more comprehensive and for all patients, On admission, we are expected to perform two RN skin check and document on LDA, and we use Braden score as our tool to predict patient’s risk of developing pressure injuries. We take photos, place in wound consult. In general, nurses are expected to initiate appropriate skin protective dressing, like mepilex on sacrum and heels and areas at risk for pressure injuries,. For skin tears we can initiate xeroform dressing and then follow the recommended treatment plan from wound care treatment team.
1. Discuss the research question or main problem discussed in the study? This research study discusses the risk of patients who are over the age of 65 and their increased risk for developing skin tears. The main purpose of the study is do identify if providing proper nursing education can help prevent the occurrence of skin related injuries. The patients who are over the age of 65 are at high risk for skin tears due to their age, fragile skin, nutritional problems, chronic illnesses, limited mobility, and a combination of other health problems. The interventions implemented to reduce skin care occurrences included using the Skin Tear Risk Assessment Tool (STRAT) and the Skin Tear Prevention Protocol (STPP). At first, the patient's that came in for their endoscopy the STRAT tool was used to assess high risk patients and appropriate interventions were taken such as using proper skin prep, adhesive remove, and other tools to prevent the skin tears from occurring.
2. What are the advantages and disadvantages of implementing the article recommendations on your unit and/or hospital?
Based on this research study it was evident that implementing simple practices such as using adhesive remover and skin prep only costs $2.00 per patient but it can provide better patient satisfaction and improved quality of life. Implementing this standardized skin education, risk assessment, and prevention on our unit can help improve the nurses' knowledge and reduce skin tear events from occurring. In this research study there was a positive correlation with improvement in nurses knowledge and skin tear reduction after the implementation of appropriate practices. As a unit we can add skin tear assessment for vulnerable patients and for high risk patients use preventative interventions appropriately. Implementing this approach can help reduce preventable skin injuries, reduce patient pain and discomfort, and most importantly improve quality of patient care.
1. Discuss the research question or main problem discussed in the study? Older patients, particularly those over the age of 65, frequently have risk factors associated with skin tear: older age, ongoing health issues, physical impairment, and thin, delicate skin. This article focused on endoscopy nurses’ knowledge of skin tear etiology and prevention. In addition, the article looked at implementing a skin tear prevention protocol in the endoscopy setting.
2. Describe the method used by the author of the study The authors began their investigation with a literature review of research on the prevalence of skin tears in healthcare and best practices for prevention. They performed a systematic review of 25 studies on skin tear pervasiveness. However, they found a dearth of research with regards to the endoscopy setting. Next the authors conducted at feasibility study over three months to determine endoscopy nurses’ knowledge about skin tears and prevention, using a questionnaire that they developed with the wound care nurses. Lastly, they analyzed the viability of implementing prevention protocol using a questionnaire which looked at the nurses’ opinion of effectiveness.
1.) Discuss the research question or main problem discussed in the study?
The main problem in this study was the increase in skin tears among patients in the endoscopy department. Older adults are especially at risk because their skin becomes thinner and more fragile as they age. The researchers wanted to find ways to prevent skin tears and improve the care of patients who are more vulnerable to these injuries. The study focused on using prevention strategies to help protect patients’ skin and reduce the number of skin tears.
2.) Discuss the limitations of the article: limited sample size, design flaws, and/or author bias?
One limitation of the article is that there was a small number of patients and nurses involved in the study, so the results may not represent what would happen with a larger group. Another limitation is that the skin tear prevention program was only used in the endoscopy department, so it is hard to know if the same results would happen in other areas of healthcare. The study also depended on staff reporting skin tears themselves, which could have caused some cases to be missed or not reported. Because of these limitations, more research with larger groups and different healthcare settings would be helpful.
1. Describe the method used by the author of the study. The authors used a pre- and post-survey to see if a skin-tear prevention program improved nurses’ knowledge. The study included 17 endoscopy nurses at HonorHealth Shea in Scottsdale, Arizona, who cared for patients 65 and older. Nurses used a risk assessment tool and prevention protocol that included safe patient handling, skin preparation, protective sleeves, and adhesive-removal products. Their knowledge was tested before the program and again after one and three months. During the study, 537 patients were identified as being at risk, and nurses completed 911 prevention interventions.
2. Discuss the limitations of the article. The study had a few limitations. It only included 17 nurses from one endoscopy facility, so the results may not apply to other healthcare settings. The study was also only three months long, making it unclear whether the improvements would last over time. Since it relied on nurses’ surveys and documentation, inconsistent reporting and compliance may have affected the results. There also was no control group, so the 88% increase in knowledge and 66% decrease in skin tears cannot be linked entirely to the intervention.
Discuss the research question or main problem discussed in the study.
This article discussed the increased risk of skin tears in adults 65 and older undergoing endoscopy procedures. As there were increased incidences of skin tears in the spring and summer months of 2022, interventions to remedy this issue were warranted. Skin tear numbers improved with a decrease in incidences of 66 percent upon nurse education consisting of risk assessments and utilization of skin tear bundles. Post education, nurses participated in surveys resulting in an increased knowledge by 88 percent.
Discuss the sample size used in the study.
The sample size included 8,203 subjects specifically looking at 4361 of those subjects being 65 and older. The focus on this study was on older adults enduring skin tears. Furthermore, the study also included the nurses caring for these patients and improvement rates followed with increased education. 537 of those patients were labeled to be high risk of being subject to skin tears.
1. Discuss the sample size study. The sample size study included 17 registered nurses who worked with older endoscopy patients. The study went on for about three months and during the studies, 603 patients were assessed for skin-tear risk, and 537 were identified as being at risk. The small number of nurses is a limitation because the results may not apply to all endoscopy nurses or other hospitals. 2. Discuss the research question or main problem discussed in the study. The research question focuses on whether educating endoscopy nurses about skin-tear prevention can improve their knowledge and help protect older patients from skin injuries. Older adults are more likely to have fragile skin, making them more likely to develop skin tears during medical procedures. The researchers wanted to see if educating the nurses about proper skincare and prevention methods would increase their understanding and improve the care they provide.
What is the research question or main problem discussed in the study ?
The main idea of this research article is to conduct a review and better understand prevention of skin tears in healthcare during endoscopy procedures. Since in recent years there has been higher number of reported incidents of skin damage the article focuses on bring awareness and creating protocols to prevent skin tears. The article focuses on developing an endoscopy specific skin tear protocol to prevent skin tears. The article researches and attempts to create skin tear prevention protocol designs, skin tear prevention bundles, identification of high risk patients. The article showed that after committing to these implementations there was significant reduction in skin tears.
What is the sample study of the article ?
The sample study of this article includes en endoscopy department with 427 beds in a community hospital in Scottsdale AZ. This department is a fast paced clinical area which includes patient’s of all ages. The study included 8203 cases out of which 4361 were 65 years and older. The study also included registered nurses how have knowledge in this specific department and have experience with adult population. The nursing experience was also important to mention for the study because nurses working in GI labs have specific work tactics and tasks.
The study's aim is to develop an evidenced-based Skin Tear Prevention Protocol for the endoscopy setting, evaluating its effectivity, and measuring nursing knowledge regarding skin tear prevention. The study developed a skin tear prevention protocol in the endoscopy setting by educating endoscopy nurses, creating a Skin tear assessment tool to identify at risk patients in the endoscopy setting above or equal to 65 years old, and applying a Skin Tear Prevention bundle to prevent skin tears. The nurses were re-evaluated in terms of their knowledge of skin tear assessment and prevention after 1 month and 3 months. The results support the aim and goal of this study in showing the benefits of having a Skin tear prevention protocol did help in identifying at risk patients, which in turn resulted in applying appropriate prevention bundle based on the assessment, thus decreasing incidence or occurrence of skin tears. The use of Skin Tear Prevention Intervention Questionnaire and the RN Opinion Opinion on Effectiveness Questionnaire were good tools to evaluate nurses knowledge on skin tear prevention.
The limitation of this study is the small sample size of patients and nurses. The project limits the age of the sample patients to equal or above 65 years because it was studied that the age demographic is more prone to developing skin tears. However, based on the study, skin injuries occurred more frequently in younger population, so further study of a larger number of sample size will be needed. Also, data collection of skin tear occurrence relies on staff reporting, which may not be perceived by staff as an opportunity for improvement but rather punitive, which may result in underreporting
How does his research article compare to our practice, policy and/or procedure?
Skin tear is often seen in our ICU, where the most of the patients are over 65 years old with critically and chronic ill as the researcher quoted the study by Van Tiggelen and Beckman. We don't know how prevalent it is in our ICU as the article mentions, either. Since we don't have skin tear risk assessment tool and skin tear prevention protocol, our action tends to be reactive treating skin tear. Treating skin tear can be dependent on each nurse's clinical knowledge/experience. In addition to that, even if we try to prevent skin tear, we have a limited resource; a phlebotomist uses non-adhesive bandage after their draw blood, while the bandage is not available for us to use currently, for example. We are trained annually for safe patient handling, where we can review ways of minimizing friction and sheering on fragile skin. In addition to that training, our use of AirTap is very helpful to reduce friction and sheering compared to mere use of sheets for vertical/lateral transfer.
What are the advantages and disadvantages of implementing the article recommendations on your unit and/or hospital?
The most advantage of implementing a skin tear prevention intervention in our ICU is that we can prevent an incident of skin tear. The skin tear prevention intervention raises Nurses awareness driving us to be proactive by assessing at-risk patients first with the skin tear risk assessment tool and carry out Skin tear prevention protocol as the article did. Skin tear prevention bundle gives us our prevention technique standardized with resources such as skin prep before using adhesives, adhesive remover wipes, stockinette. Personally, I'd like to add 'Pain-Free wrap,' which is used by a phlebotomist after their blood draw, to our ICU Skin tear Prevention Bundle. The cost of prevention bundle in the article is less than $2, which is cost effective and easy to implement the bundle. Other advantage is that it can contribute to increase job satisfaction/retention since the protocol is Nurse-led initiatives which enhances our autonomy. Other advantage is that we already have an annual training of safe patient handling to review how to minimize friction and sheering forces.
Disadvantage would be that we cannot use their skin tear prevention intervention without revision since their setting is focus on endoscopic procedures, so their routine is different from ICU's. For example, ERCP is rather rare case in our ICU. We need to develop our own tool for our ICU.
Discuss the research question or main problem in the study:
The study focused on endoscopy patients aged 65 and older who are at higher risk for skin tears due to fragile skin, chronic health conditions, and limited mobility. The researchers wanted to determine whether evidence-based skin tear prevention protocol could increase nurses' knowledge and reduce the number of skin tears in older endoscopy patients. The main question was whether implementing a skin tear protocol can improve patient safety and to identify high risk patients to prevent avoidable skin injuries.
Discuss the sample size used in the study:
The study was conducted in the endoscopy department of a 27- bed community hospital in Scottsdale, Arizona. In 2022, the department treated 8.203 patients including 4,361 patients aged 65 years and older, who represented the population at higher risk for skin tears. The sample consisted of registered nurses with adult endoscopy patients who completed at least two of the three study questionnaires. The nurses had an average of 14.7 year of nursing experience. The education and experience levels of the endoscopy nurses included 55% BSN, 13.5 MSN, 13.5 ADN, and 18% Diploma.
1). Discuss the research question or main problem discussed in the study?
The main problem the study tackles is an increase in skin tears among older endoscopy patients, who commonly have fragile skin and other risk factors, in a unit that had no formal screening or prevention process. The project asked whether creating and rolling out an endoscopy-specific prevention protocol—risk assessment plus a simple bundle of skin-prep wipes, limb coverings, safe handling, and adhesive removers—together with staff education, would improve nurses’ knowledge and lower tear rates. Over three months the team tracked protocol use, surveyed knowledge at three time points, and compared tear counts, reporting both a large gain in knowledge and a substantial drop in new tears.
2). What are the advantages and disadvantages to the proposed recommendations in the article?
The article recommends screening endoscopy patients with a skin-tear risk tool, using a low-cost bundle of prep and remover wipes, stockinette, and safe handling, applying it to all patients, documenting it in the EMR, and sustaining it with education, audits, and a champion. These steps increase nurse knowledge, appear to cut reported tears, cost little, and improve safety and staff autonomy. Limits include a small volunteer sample and self-reported tear data that may undercount events. Fit outside endoscopy is unproven, the extra work can burden nurses, and no formal cost-benefit analysis was done, so lasting impact remains uncertain.
1. Describe the method used by the author of the study.
The authors used an evidence-based quality improvement project and feasibility study with a pre-test/post-test survey design. The study was conducted over three months in an endoscopy department. The researchers developed and implemented a skin tear prevention protocol and educated the nurses. The researchers measured nurses’ knowledge about skin tear prevention before the intervention, one month after, and three months after. The researchers also examined whether the prevention protocol reduced skin tears in patients. This method was appropriate because it allowed the researchers to compare the nurses’ knowledge before and after the education and determine whether the new prevention protocol was effective.
2. Discuss the sample size used in the study.
The study included 17 endoscopy nurses who completed at least two of the three questionnaires and were included in the results. During the 12-week study, 603 skin tear risk assessments were completed on patients aged 65 and older, and 537 patients were identified as being at risk for skin tears. The sample was useful for a small feasibility and quality improvement study, but it was still limited. The authors acknowledged that the small number of nurses and patients means that more research with larger samples is needed to confirm the findings.
Discuss the sample size used in the study
ReplyDelete-The endoscopy department of 427 bed suburban community hospital served as a setting for the evidence- based skin tear prevention quality improvement project. Patients in endoscopy may originate from out patient ,inpatient, emergency room or ICU.The inclusion criteria for the study included registered nurses working with adult patients in endoscopy who had completed at least two of the three STPQIs (Skin Tear Prevention Intervention Questionnaire ) Nursing experience averaged 14.7 years for theses endoscopy nurses.
Describe the method used by the author of the study
- A multidisciplinary approach was implemented to create an endoscopic specific STPP Skin Tear Prevention Protocol, including review of current literature and collaboration with wound care nurse, physical therapists and endoscopy staff. Appropriate prevention measures identified for endoscopy included staff education on best practice, identification of at risk patients, and using a skin tear prevention bundle. For 12 weeks of study, a paper copy of the STRAT ( skin tear risk assessment tool) was placed in patient’s medical chart.If patient was identified at risk , the nurse initiated appropriate STPP ( skin tear prevention protocol).It was then communicated between admitting and procedural nurse.The procedural nurse is responsible for continuing the STPP.The procedural nurse then communicated the risk assessment to recovery nurse who then continued the STPP. The admitting, procedural and recovery nurse are all responsible for verifying that documentation has been completed and that any new skin tear have been appropriately reported.
Research Question: Between spring and summer of 2022, a noticeable increase in skin tears was identified in the endoscopy department of a 427-bed suburban community hospital in Scottsdale, AZ. The goal of this evidence-based quality improvement project and feasibility study with a pre/post-timed series survey design had three main goals: to design and implement an evidence-based skin tear prevention protocol for endoscopy, evaluate this protocol for usability and effectiveness, and assess endoscopy nurse's skin tear prevention knowledge. A literature review revealed that no studies on skin tear incidents or prevention in the endoscopy setting could be found leaving the question related to best practices for skin tear prevention in endoscopy unanswered. A multidisciplinary team approach was needed. One survey revealed a concerning lack of knowledge among nurses regarding skin tear risk assessment, prevention and treatment regardless of their educational background and experience. A systematic review found that implementing a skin tear bundle, regardless of the individual components, leads to decreased skin tear incidence, and early identification of at-risk patients is key. Additional studies regarding safe patient handling to prevent tears from friction and sheering, the use of limb coverings and best practice adhesive removal strategies in settings other than that of endoscopy were reviewed.
ReplyDeleteMethods: A feasibility study with a pre/post-timed series survey design was developed and conducted over three months to assess nursing knowledge and the effectiveness of the STPP on skin tear prevention. The authors developed a Skin Tear Prevention Intervention Questionnaire (STPIQ) in collaboration with wound care nurses. A scoring tool was utilized to evaluate the STPIQ content for validity and reliability, and questionnaire was then utilized with endoscopy nurses at baseline, one month and three months. A PowerPoint presentation summarizing skin tear prevention measures specific to the endoscopy setting was provided to staff via work emails, presented at staff meetings and discussed in walking rounds. The Skin Tear Risk Assessment Tool (STRAT) was adapted for the endoscopy setting and was completed on all patients ages 65 or older upon admission and included a list of skin tear risk factors, suggested interventions based on the risk assessment, and a reminder to complete all documentation. The admitting, procedural, and recovery nurses were all responsible for completing the STRAT and implementing the appropriate STPP interventions. The endoscopy nurses implemented 911 skin tear prevention interventions and there was a 66% reduction in skin tears over the three months of the study.
How does this research article compare to our practice, policy, and procedure? In this article the staff took a multifaceted approach that included teaching, assessing patients for risk factors, and skin tear prevention protocol implementation. In our practice I feel that although during our assessment we identify patients at risk for shearing and skin tear injuries, that all to often we rush and do not implement proper prevention such as proper lifting equipment or using adhesive remover even though these tools are readily available. I feel that with more education and reinforcement of policies and procedures the hospital as a whole might be able to cut down on skin tear injuries, much like was done in this study.
ReplyDeleteWhat are the advantages and disadvantages to the proposed recommendations in the article? The advantages to the proposed recommendations in the article would be to reduce the number of skin tears suffered during the hospital stay. This would greatly improve patient satisfaction and outcomes and also reduce costs in extra resources, time, diagnostics, and treatment and law suits that may arise from skin tears that arise from improper care. The disadvantages of the recommendations proposed in this article is the extra cost of educating the staff and the time it would take to implement even more policy and procedure into an already cramped schedule. Overall I believe the benefits outweigh the costs of implementing the recommendations of the skin tear prevention interventions.
ReplyDeleteApril article: Assessing Knowledge Among Endoscopy Nurses With Implementation of a Skin Tear
ReplyDeletePrevention Intervention
Question #1: Discuss the sample size used in the study.
The endoscopy department of a 427-bed suburban community hospital in Scottsdale, AZ, served as the setting for this evidence-based skin tear prevention quality improvement project. Endoscopy is a fast-paced and vibrant patient care area that serves high and low- acuity patients of all ages. Patients in endoscopy could have originated as outpatients, inpatients, from the emergency room, or the ICU. The inclusion criteria for the study involved registered nurses working with adult patients in endoscopy who had completed at least two of the three STPQIs (Skin Tear Prevention Intervention Questionnaire ). Nursing experience averaged was 14.7 years for theses endoscopy nurses.
Question #2: What are the advantages and disadvantages to the proposed recommendations in the article?
The article proposed Skin Tear Prevention Protocol Design. The proposal included on educating staff on best practices, identifying at-risk patients, and using a skin tear prevention bundle that includes skin preparation wipes, stockinette limb coverings, safe patient handling techniques, and adhesive remover wipes. The form of education included a power point presentation summarizing the skin tear prevention measures to endoscopy setting, printed educational materials, rounds discussion.
Skin Tear Prevention Bundle included applying skin prep before using adhesives, using adhesive remover wipes, for all tape and dressing removal, placing stockinette sleeves on the upper extremities if proning or turning the patient, and employing proper techniques while moving and repositioning patients.
I see these proposals as more advantageous not just in the endoscopy settings but wherever & whenever it is necessary, especially while a patient is hospitalized. The advantages can comprise of providing better if not excellent care to patients, improve nursing skills competence, lesser number of hospitalizations days related to complications, etc.
What I see as a disadvantage is the cost. Although it is projected as less than $ 2 per patient with cumulative cost, it will an additional expenditure.
March article: Leaving Slings and Other Transfer Devices Under Patients: A Clinical Decision Support Quality Improvement Project
ReplyDeleteQuestion # 1: Discuss the research question or main problem discussed in the study?
The article's evidence suggested that sling and transfer device use is a cause of hospital-acquired pressure injuries, and therefore skin protection must be considered when using these devices. The Veterans Health Administration facilities utilize fabric slings with safe patient handling and mobility equipment for patient transfers. Knowledge or best practice regarding the safety of leaving slings under patients' skin has not been established. To address this evidence gap, the Veterans Integrated Services Network (VISN) Patient Safety Center of Inquiry (PSCI) conducted a quality improvement project to develop guidance regarding leaving slings and other transfer devices under patients and
potential for skin or pressure injury risk. The purpose of this report is to describe current use of slings and transfer devices at VHA facilities and introduce a guidance document that may be used to facilitate best practices in use of transfer equipment
Question #2: Describe the method used by the author of the study
Quality improvement project activities were conducted from October 2019 to September 2021 using a mixed-methods rapid assessment approach. The objectives were to collect data about common practices at VHA facilities related to leaving slings under patients, examine reported patient transfer practices and associations with rates of inpatient pressure
injuries, and evaluate current practices against best available evidence to develop guidance about safely using slings to reduce pressure injury and skin injury risk. The data collection techniques were cross-sectional surveys, electronic health record review, and qualitative interviews. This project was determined to be quality improvement (QI) by the James A. Haley Veterans’ Hospital Research and Development Committee and therefore exempt from additional Institutional Review Board.
The feedback on practices and perceptions related to leaving slings and other transfer devices was evaluated using online cross-sectional surveys and interviews with VHA staff. Secondary data for VHA inpatient rates of pressure injury were used to examine associations with staff-reported sling and other transfer device practices.
February article: Intensive Care and Operating Room Nurses’ Knowledge Regarding Skin Tears
ReplyDeleteQuestion #1 Discuss the research question or main problem discussed in the study?
Skin tears are common injuries, especially in hospital-based settings such as intensive care and operating rooms. These injuries usually occur as a result of skin vulnerability and incorrect use of medical devices. Nurses have an important role in the prevention, early detection and management of skin tears. Previous research has shown that nurses' knowledge of skin tears varies and is sometimes inadequate. There are a limited number of studies comparing the knowledge levels of operating room and intensive care nurses.
The questions that were addressed in this study were the level of knowledge of operating room and intensive care nurses regarding skin tear and the factors that are affecting their level of knowledge.
Question #2: Discuss the limitations of the article: limited sample size, design flaws, and/or author bias
This study has several limitations which should be taken into consideration when interpreting the findings. The sample of the study was limited to nurses in a specific institution, and the generalizability of the results to the entire population of nurses is limited. Data were collected through self-report, and nurses' preventive interventions for skin tears and the accuracy of their implementation could not be assessed through direct observation. Therefore, additional research is recommended to determine the factors that prevent the dissemination of accurate knowledge and practices and the underlying causes of these factors.
January article: Predictors of Patient Participation in Pressure Injury Prevention: An Observational Sub study
ReplyDeleteQuestion #1 Discuss the sample size used in the study
The parent trial inclusion criteria were adults admitted in the previous 36h to medical and surgical units of three large metropolitan hospitals, whose expected hospital length of stay was greater than 24h and who were at high risk for a pressure injury. In the state where the study took place, hospitals used the Water low scale as a risk assessment tool. Therefore, patients at risk of pressure injury were defined as either a Water low score of ≥10 or patients who had limited mobility. Patients were excluded if they were unable to be turned, had an existing sacral pressure injury or other lesion in the sacral area at the time they were recruited, had urinary or fecal incontinence , or were unable to speak or understand English if no interpreter was present. When individuals are incontinent, the dressing manufacturer recommends a different process for dressing application, which introduces a
difference in the way the dressings are applied within the intervention group. Therefore, the parent trial excluded patients with Incontinence. All participants in the parent trial were included in this analysis. A power analysis showed that with eight predictors, a sample size of 766 would have >95% power to detect a small effect (0.03) with an alpha of p<0.05 [27]. This sample size also allows us to assess the scale's psychometric properties
Question #2 Discuss the limitations of the article: limited sample size, design flaws, and/or author bias
This study has several strengths, including its large, adequately Powered sample, providing confidence in the study's results. They also used an instrument that had previously been shown to be valid and reliable. While most fit statistics were met in their study, and were similar to those previously reported for this scale, two were not. However, given the chi-square is sensitive to large samples, this was not unexpected. Additionally, room mean square error of approximation values of 0.05 to 0.08 are generally considered acceptable, with values 0.0.08–0.1 marginally acceptable, thus some use the criteria of <0.10 [29, 36] which was met in their study. Thus, we conclude the PPPIP scale is valid and reliable.
This research also has some limitations. First, because participants were part of a larger clinical trial with strict inclusion and exclusion criteria, the findings may not be generalizable to patients not at pressure injury risk, not incontinent, or not in a pressure injury study. Second, they did not have data on patients' current health status. They used the number of comorbidities as a proxy for health status, but recognize the two are not the same. Third, we they not measure actual PIP behavior; patient participation was self-reported. Finally, their model predicted a very small amount of variance in scale scores.
Bethany Sobesto 5/16/26
ReplyDeleteDiscuss the limitations of the article: limited sample size, design flaws, and/or author bias
The sample size was small and they only included patients in the GI endoscopy area. More studies need to be done to see if is feasible to do the skin tear risk assessments on other floors in the hospital. Also, the number of skin tears reported relied on nurses reporting of them. This self reporting may not have been accurate or reliable since some nurses are not honest about the number of skin tears they assess or they are too busy to do a thorough assessment of the patients.
What are the advantages and disadvantages to the proposed recommendations in the article?
The advantages would be a decrease in the number of skin tears in patients and potentially a higher patient patient satisfaction score. As more nurses are educated on how to prevent skin tears, they can do things such as use adhesive remover when removing a dressing, use no sting barrier to protect skin before applying an IV tegaderm dressing, and be careful not to quickly/aggressively rip off tape from the patient's skin. A disadvantage is the time it takes to educate nurses on skin tear prevention and the increase in cost associated with having to use extra supplies. Although, the increase in cost was only $2 per patient in this research study, so I believe the increase in cost is worth it to help protect the patient's skin.
Discuss the sample size used in the study
ReplyDeleteA feasibility study was used to measure nursing knowledge on skin tear prevention in endoscopy and nurse satisfaction with the skin tear prevention protocol .A pre/post survey was used to measure nursing knowledge at baseline ,one month ,and three months post protocol implementation.Over the three month study 537 endoscopy patients >65 years old were identified to be at risk for skin tears .Endoscopy nurses implemented 911 skin tear prevention nursing interventions.This project demonstrated an 88% gain in nursing knowledge and a 66% skin tear reduction in endoscopy .The findings provide an optimistic outlook for skin tear prevention in endoscopy settings .
For assessing endoscopy nurses during new protocol or checklist implementations ,a sample size of 60-120 participants (or about 30 to 60 per group )is typical for experiment or pilot studies
Endoscopy patients >65 years old who often present with the risk factor for skin tears ,e.g advanced age ,chronic health issues ,limited mobility, and compromised integumentary ,were the focus of a skin tear prevention intervention .This evidence -based quality improvement project and feasibility study with a pre/post timed series survey design had three main goals to design and implement an evidence based skin tear prevention protocol for endoscopy ,evaluate this protocol for usability and effectiveness and assess endoscopy nurses skin tear prevention knowledge .
What are the advantages and disadvantages to the proposed recommendations in the article?
ReplyDeleteImplementing a skin tear prevention and management protocol in an endoscopy setting offers significant clinical and operational benefits ,primarily by reducing patient and injury ,but requires navigating some practical challenges like additional staff documentation .Advantages such as Fewer Injuries and less pain by utilizing risk assessment tools and safety equipment
.Cost Efficiency by preventing tears translates directly to lower material usage ,shorter patient turnaround times and reduced health care cost
..Improved knowledge and Satisfaction by education initiatives yields substantial gains in nursing confidence, enabling staff to handle acute wounds quickly and effectively.Better Patient Experience by avoiding traumatic wounds protects patient dignity and satisfaction
While the Disadvantages are as follows
Increased initial workload by admitting and procedural nurses must take the time to complete risk assessments and communicate per patient skin tear risk
Documentation Burden by which nurses face the added task or detailed clinical documentation -classifying the wound and recording the exact cause and treatment pathway
Learning curve by which adapting to modern wound management techniques
Fast Paced Constraints wherein taking time to precisely reapproximate tiny ,fragile skin flaps can be challenging during busy quick turn around lists .
Discuss the sample size used in the study.
ReplyDeleteThe research study focused on a specific endoscopy department in a 427 bed hospital located in Scottsdale, AZ. IN 2022, this specific endoscopy center saw 8,203 patients. Inclusion criteria for study focused on nursing knowledge and feasibility study included RNs working with adult patients who have completed 2 or 3 STPIQs. Education and experience levels were also evaluated for the nurses raging from diploma to MSN degrees. the average years of experience for the nurses was 14.7 years.
Discuss the research question or main problem discussed in the study?
The research article examines best practice strategies to reduce skin tears of patients within the endoscopy setting. It was found that in the spring and summer at a specific center that there was a notable increase in skin tears. There was no specific risk assessment or protocol prevention in place to help the population, especially those in older adults. The study found findings from the literature, and provided opportunities for skin tear prevention strategies.
Discuss the research question or main problem discussed in the study?
ReplyDeleteThe main problem addressed in this study was a significant and unexplained increase in skin tears identified within an endoscopy department during the spring and summer of 2022. It's critical to highlight that the department lacked any standardized risk assessment tool or prevention policy at the time, leaving a vulnerable population of older adults at higher risk for injury. The research sought to determine if the implementation of an evidence based skin tear prevention policy could effectively reduce these incidents while simultaneously improving the knowledge of endoscopy nurses. This problem is particularly relevant because skin tears in procedural settings like endoscopy are often underreported and under researched, making it difficult to establish best practices for this specific clinical environment. By focusing on patients aged 65 and older who possess risk factors like fragile skin and polypharmacy, the study aimed to prove that these injuries are not inevitable but are preventable with the appropriate interventions.
Discuss the limitations of the article: limited sample size, design flaws, and/or author bias.
One of the biggest limitations of this research is the small and localized sample size, as the study was conducted within a single endoscopy department at one community hospital. This narrow focus limits our ability to generalize the findings to other units or larger hospitals. A potential design flaw exists in the study’s reliance on self reporting for the occurrence of skin tears. This creates an unreliable measure of success because nurses might not report injuries if they think the process as punitive or they may feel as if they're too busy to perform a thorough skin assessment during a busy shift. Additionally, because participation was voluntary the researchers acknowledged that the data might not capture the full range of knowledge or experience within the department.
April 2026
ReplyDeleteDiscuss the sample size used in the study.
The sample size of this study was in the endoscopy department located at a community hospital in Scottsdale, Arizona. Patient that are seen in the endoscopy department range from low acuity to high acuity and are all ages. Patients could come from out-patient, in-patient, the emergency department, or the ICU. This made the endoscopy department a great place to serve as the setting got the skin tear prevention QI project since they saw 8,203 patients in 2022 and 4,361 of those patients were aged 65 or older. The inclusion criteria for this study included nurses who work with adult’s patient in endoscopy who have completed at least two of the three Skin Tear Prevention Intervention Questionnaire. The nurses who participated had the following characteristics: 55% had a BSN, 13.5% had an MSN, 13.5% had an AND, and 17% diploma nurses. The average experience level for the endoscopy nurses was on average 14.7 years.
Discuss the research question or main problem discussed in the study.
As people age, their skin becomes increasingly thin and fragile, therefore patients who are 65 years or older they are at an increased risk for skin tears. Therefore, while providing care to the aging population, more precautions should be utilized to prevent skin tears and preserve skin integrity. This article looks to better understand the prevalence of skin tears and prevention of skin tears in the endoscopy setting. The findings from the study served as the framework for developing skin tear prevention protocols specifically for patients who are in the endoscopy setting. The writers of this article were not able to find any studies that focus primarily on the incident or prevention of skin tears in the endoscopy setting. The study actually led to positive results to all three of the study aims. There was an increase in knowledge of endoscopy skin tear prevention, an overall agreement among the endoscopy nurses that the prevention protocol increases patient safety, and there was an overall reduction in skin years over a 12-week period.
Discuss the sample size used in the study:
ReplyDeleteThe sample size for this study was 4,361 patients, with the criteria being endoscopy patients at a suburban community hospital who were also over the age of 65 years of age. These patients were a mixture of outpatient, inpatient, ER, and ICU patients. The other key part of this study was the nursing knowledge piece. Registered nurses in the endoscopy department completed at least two of the three skin tear prevention intervention questionnaire. Nursing experience was calculated at an average of 14.7 years for the endoscopy nurses who cared for the sample patients.
What are the advantages and disadvantages to the proposed recommendations in the article?
During the study, there was a 66% reduction in skin tears. There was also reported to be an 88% increase in nursing knowledge on skin tear prevention. The cost of the skin tear prevention bundle was estimated to be less than $2.00 per patient (skin prep wipes, adhesive remover wipes, and stockinette sleeves). With the increase in safety, better patient outcomes, and reduction of skin tears, it is very clear that the advantages outweigh the cost related to the bundle. In addition, nurses report that their nursing autonomy in initiating care bundles is linked with improved job satisfaction as well as nurse retention.
Describe the method used by the author of the study.
ReplyDeleteThe study used an evidenced-based quality improvement project and feasibility-study methodology, employing a pre and post timed series survey design. It was not a randomized controlled trial. The study supports observing improvement over time but without randomization or a control group. The team used a multidisciplinary process to develop the protocol and measured the nurses' knowledge with surveys at baseline, one month, and three months after the implementation. They also assessed the protocol's usability, effectiveness, and nurses' satisfaction.
Discuss the main problem discussed in the study.
It evaluated an endoscopy-specific skin tear prevention protocol for patients aged 65 years and older suggesting that a structured, setting-specific prevention protocol paired with nurse education can improve staff knowledge and reduce this avoidable injury. It is in the premise of the study that older endoscopy patients may be susceptible to skin tears because of factors such as frail skin, presence of chronic conditions, reduced mobility, and impaired skin barrier state compromising its integrity from the use of different kinds of adhesives- which is inherent in all units, as a matter of fact.
1) Discuss the research question or main problem discussed in the study?
ReplyDeleteThe main problem discussed in the study was the high risk of skin tears among older adults receiving care in the endoscopy department. The researchers wanted to determine whether an evidence-based Skin Tear Prevention Protocol (STPP) could improve nurses’ knowledge and reduce skin tears. The study also evaluated whether the Skin Tear Risk Assessment Tool (STRAT) was useful for identifying patients at risk and guiding prevention interventions. After implementation, nursing knowledge increased by 88% and skin tears decreased by 66%, suggesting that the protocol was effective in improving patient safety.
2) Discuss the limitations of the article: limited sample size, design flaws, and/or author bias
The study had a small sample size, with only 22 nurses participating and 17 included in the final knowledge analysis, which limits the ability to generalize the findings. The pre/post study design did not include a control group, making it difficult to determine whether the reduction in skin tears was caused specifically by the intervention. Skin-tear reporting depended on staff self-reporting, which could have resulted in underreporting or biased results. Additionally, the authors developed their own questionnaire and were involved in implementing the intervention, which may introduce measurement and researcher bias and affect the reliability of the findings.
1. Describe the method used by the author of the study.
ReplyDeleteThe study applied a multidisciplinary approach with the main goal of decreasing the incidence of skin tears in patients 65 years old or older in an endoscopy setting. The first step was to create a feasibility study with a pre- and post-intervention survey through the development and utilization of a Skin Tear Prevention Intervention Questionnaire. This tool was tested for validity and reliability through a subset of peri-anesthesia nurses, and once that was established was then brought to endoscopy nurses for a baseline survey, at one month and then at three months post-intervention to assess any changes in skin tear knowledge. Concurrently with the 3-month survey, nurses were also given the RN Opinion of Effectiveness Questionnaire to assess the feasibility of the skin tear prevention protocol (STPP).
2. Discuss the limitations of the article: limited sample size, design flaws, and/or author bias.
The authors discuss the limits of a small sample size including both patients and nurses and the need to gather more data in order to substantiate their findings. Another limitation is the specificity of using just the endoscopy unit and whether this protocol can effectively be used in other patient care units. In addition, participation in the study was voluntary and may not reflect the knowledge of all of the nurses nor the more accurate percentage of improvement in knowledge. Answers were also self-reported and may reflect answers guided out of fear of punitive measures versus honest answers that reflect the true scope of the issues and how to improve them.
1. Describe the method used by the author of the study.
ReplyDeleteA series survey design was utilized as the method used. It was conducted over a three month period to assess nursing knowledge and the effectiveness of the skin tear prevention protocol (STPP) on skin tear prevention. The authors conducted the survey with the Skin Tear Prevention Intervention Questionnaire that they developed in collaboration with wound care nurses. A scoring tool was used to evaluate the questionnaire for validity and reliability. The findings were used for three different aims including developing an STPP protocol for the endoscopy setting, evaluating its effectiveness and use and measuring nursing knowledge regarding skin tear prevention.
2. Discuss the sample size used in the study.
The sample size used in this study included registered nurses working with adult patients in endoscopy. The education level of the nurses were mixed with 55% BSN, 13.5% MSN, 13.5% ADN and 18% diploma. Nursing experience averaged 14.7 years. These nurses worked in the endoscopy department of a 427 bed community hospital in Scottsdale, Arizona.
Discuss the research question or main problem discussed in the study?
ReplyDeleteSkin tears occur, but there is increased risk for skin tears in older patients due to the decrease in collagen productions resulting in less elasticity and thinning of the skin. This study is looking at adults that are 65 years old and older that are having an endoscopy procedure. As the study points out, many skin tears heal on their own with minimal intervention, however there is a risk of the skin tear developing into a bigger/chronic wound. There was an increase in skin tears from spring and summer of 2022 identified in endoscopy patients. Therefore, skin tear preventions were implemented in the endoscopy care setting, skin tear prevention consisted of providing education to the nurses and the implementation of a skin tear bundle. The article then identified that by providing education to the nurses on risk assessment to identify high risk patients and use of the skin tear bundle, the incidence of skin tears in the endoscopy setting decreased by 66%.
Discuss the sample size used in the study.
The setting used for this study was the endoscopy department of a hospital in Scottsdale Arizona. The study conducted was an evidence-based study that went on for three months, the number of patients cared for in the endoscopy department were 8,203, with 4,361 of those patients being 65 or older. The study’s aim was to assess the knowledge among endoscopy nurses, the education level of the endoscopy nurses were 55% BSN, 13.5% MSN, 13.5% ABD, and 18% diploma, with the average years of nursing experience being 14.7yr. The survey conducted showed an 88% increase in nursing knowledge.
Discuss the research question or main problem discussed in the study?
ReplyDeleteEndoscopy setting had a notable increase in skin tears, the department had no specific protocol for skin tear risk assessment or prevention in place which prompted the staff to identify best practices of skin tear prevention. The study address three main goal: to implement evidence-based skin tear prevention for endoscopy patients, evaluate protocol for effectiveness and assess nurse’s skin tear prevention knowledge. Education on skin tear prevention was disseminated via email and staff meetings and printed materials. To identify at-risk patients Skin Tear Risk Assessment Tool (STRAT) was included upon admission and to be completed on patients over 65 year old. If the pt was identified at risk for skin tear, skin tear prevention protocol was implemented which involves using appropriate intervention for such as using skin prep wipes before placing adhesives and using adhesive remover wipes. applying sleeves to upper extremities. These implementation resulted to 66% reduction in skin tears over the three month period and increase in nursing knowledge.
How does this research article compare to our practice, policy and procedure?
In this study they used skin tear tool assessment tool to assess patients over 65 for patients. In inpatient setting, skin assessment is more comprehensive and for all patients, On admission, we are expected to perform two RN skin check and document on LDA, and we use Braden score as our tool to predict patient’s risk of developing pressure injuries. We take photos, place in wound consult. In general, nurses are expected to initiate appropriate skin protective dressing, like mepilex on sacrum and heels and areas at risk for pressure injuries,. For skin tears we can initiate xeroform dressing and then follow the recommended treatment plan from wound care treatment team.
1. Discuss the research question or main problem discussed in the study?
ReplyDeleteThis research study discusses the risk of patients who are over the age of 65 and their increased risk for developing skin tears. The main purpose of the study is do identify if providing proper nursing education can help prevent the occurrence of skin related injuries. The patients who are over the age of 65 are at high risk for skin tears due to their age, fragile skin, nutritional problems, chronic illnesses, limited mobility, and a combination of other health problems. The interventions implemented to reduce skin care occurrences included using the Skin Tear Risk Assessment Tool (STRAT) and the Skin Tear Prevention Protocol (STPP). At first, the patient's that came in for their endoscopy the STRAT tool was used to assess high risk patients and appropriate interventions were taken such as using proper skin prep, adhesive remove, and other tools to prevent the skin tears from occurring.
2. What are the advantages and disadvantages of implementing the article recommendations on your unit and/or hospital?
Based on this research study it was evident that implementing simple practices such as using adhesive remover and skin prep only costs $2.00 per patient but it can provide better patient satisfaction and improved quality of life. Implementing this standardized skin education, risk assessment, and prevention on our unit can help improve the nurses' knowledge and reduce skin tear events from occurring. In this research study there was a positive correlation with improvement in nurses knowledge and skin tear reduction after the implementation of appropriate practices. As a unit we can add skin tear assessment for vulnerable patients and for high risk patients use preventative interventions appropriately. Implementing this approach can help reduce preventable skin injuries, reduce patient pain and discomfort, and most importantly improve quality of patient care.
1. Discuss the research question or main problem discussed in the study?
ReplyDeleteOlder patients, particularly those over the age of 65, frequently have risk factors associated with skin tear: older age, ongoing health issues, physical impairment, and thin, delicate skin. This article focused on endoscopy nurses’ knowledge of skin tear etiology and prevention. In addition, the article looked at implementing a skin tear prevention protocol in the endoscopy setting.
2. Describe the method used by the author of the study
The authors began their investigation with a literature review of research on the prevalence of skin tears in healthcare and best practices for prevention. They performed a systematic review of 25 studies on skin tear pervasiveness. However, they found a dearth of research with regards to the endoscopy setting. Next the authors conducted at feasibility study over three months to determine endoscopy nurses’ knowledge about skin tears and prevention, using a questionnaire that they developed with the wound care nurses. Lastly, they analyzed the viability of implementing prevention protocol using a questionnaire which looked at the nurses’ opinion of effectiveness.
1.) Discuss the research question or main problem discussed in the study?
ReplyDeleteThe main problem in this study was the increase in skin tears among patients in the endoscopy department. Older adults are especially at risk because their skin becomes thinner and more fragile as they age. The researchers wanted to find ways to prevent skin tears and improve the care of patients who are more vulnerable to these injuries. The study focused on using prevention strategies to help protect patients’ skin and reduce the number of skin tears.
2.) Discuss the limitations of the article: limited sample size, design flaws, and/or author bias?
One limitation of the article is that there was a small number of patients and nurses involved in the study, so the results may not represent what would happen with a larger group. Another limitation is that the skin tear prevention program was only used in the endoscopy department, so it is hard to know if the same results would happen in other areas of healthcare. The study also depended on staff reporting skin tears themselves, which could have caused some cases to be missed or not reported. Because of these limitations, more research with larger groups and different healthcare settings would be helpful.
1. Describe the method used by the author of the study.
ReplyDeleteThe authors used a pre- and post-survey to see if a skin-tear prevention program improved nurses’ knowledge. The study included 17 endoscopy nurses at HonorHealth Shea in Scottsdale, Arizona, who cared for patients 65 and older. Nurses used a risk assessment tool and prevention protocol that included safe patient handling, skin preparation, protective sleeves, and adhesive-removal products. Their knowledge was tested before the program and again after one and three months. During the study, 537 patients were identified as being at risk, and nurses completed 911 prevention interventions.
2. Discuss the limitations of the article.
The study had a few limitations. It only included 17 nurses from one endoscopy facility, so the results may not apply to other healthcare settings. The study was also only three months long, making it unclear whether the improvements would last over time. Since it relied on nurses’ surveys and documentation, inconsistent reporting and compliance may have affected the results. There also was no control group, so the 88% increase in knowledge and 66% decrease in skin tears cannot be linked entirely to the intervention.
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ReplyDeleteValarie Renaux ICU
ReplyDeleteDiscuss the research question or main problem discussed in the study.
This article discussed the increased risk of skin tears in adults 65 and older undergoing endoscopy procedures. As there were increased incidences of skin tears in the spring and summer months of 2022, interventions to remedy this issue were warranted. Skin tear numbers improved with a decrease in incidences of 66 percent upon nurse education consisting of risk assessments and utilization of skin tear bundles. Post education, nurses participated in surveys resulting in an increased knowledge by 88 percent.
Discuss the sample size used in the study.
The sample size included 8,203 subjects specifically looking at 4361 of those subjects being 65 and older. The focus on this study was on older adults enduring skin tears. Furthermore, the study also included the nurses caring for these patients and improvement rates followed with increased education. 537 of those patients were labeled to be high risk of being subject to skin tears.
1. Discuss the sample size study.
ReplyDeleteThe sample size study included 17 registered nurses who worked with older endoscopy patients. The study went on for about three months and during the studies, 603 patients were assessed for skin-tear risk, and 537 were identified as being at risk. The small number of nurses is a limitation because the results may not apply to all endoscopy nurses or other hospitals.
2. Discuss the research question or main problem discussed in the study.
The research question focuses on whether educating endoscopy nurses about skin-tear prevention can improve their knowledge and help protect older patients from skin injuries.
Older adults are more likely to have fragile skin, making them more likely to develop skin tears during medical procedures. The researchers wanted to see if educating the nurses about proper skincare and prevention methods would increase their understanding and improve the care they provide.
What is the research question or main problem discussed in the study ?
ReplyDeleteThe main idea of this research article is to conduct a review and better understand prevention of skin tears in healthcare during endoscopy procedures. Since in recent years there has been higher number of reported incidents of skin damage the article focuses on bring awareness and creating protocols to prevent skin tears. The article focuses on developing an endoscopy specific skin tear protocol to prevent skin tears. The article researches and attempts to create skin tear prevention protocol designs, skin tear prevention bundles, identification of high risk patients. The article showed that after committing to these implementations there was significant reduction in skin tears.
What is the sample study of the article ?
The sample study of this article includes en endoscopy department with 427 beds in a community hospital in Scottsdale AZ. This department is a fast paced clinical area which includes patient’s of all ages. The study included 8203 cases out of which 4361 were 65 years and older. The study also included registered nurses how have knowledge in this specific department and have experience with adult population. The nursing experience was also important to mention for the study because nurses working in GI labs have specific work tactics and tasks.
The study's aim is to develop an evidenced-based Skin Tear Prevention Protocol for the endoscopy setting, evaluating its effectivity, and measuring nursing knowledge regarding skin tear prevention.
ReplyDeleteThe study developed a skin tear prevention protocol in the endoscopy setting by educating endoscopy nurses, creating a Skin tear assessment tool to identify at risk patients in the endoscopy setting above or equal to 65 years old, and applying a Skin Tear Prevention bundle to prevent skin tears. The nurses were re-evaluated in terms of their knowledge of skin tear assessment and prevention after 1 month and 3 months. The results support the aim and goal of this study in showing the benefits of having a Skin tear prevention protocol did help in identifying at risk patients, which in turn resulted in applying appropriate prevention bundle based on the assessment, thus decreasing incidence or occurrence of skin tears. The use of Skin Tear Prevention Intervention Questionnaire and the RN Opinion Opinion on Effectiveness Questionnaire were good tools to evaluate nurses knowledge on skin tear prevention.
The limitation of this study is the small sample size of patients and nurses. The project limits the age of the sample patients to equal or above 65 years because it was studied that the age demographic is more prone to developing skin tears. However, based on the study, skin injuries occurred more frequently in younger population, so further study of a larger number of sample size will be needed.
ReplyDeleteAlso, data collection of skin tear occurrence relies on staff reporting, which may not be perceived by staff as an opportunity for improvement but rather punitive, which may result in underreporting
How does his research article compare to our practice, policy and/or procedure?
ReplyDeleteSkin tear is often seen in our ICU, where the most of the patients are over 65 years old with critically and chronic ill as the researcher quoted the study by Van Tiggelen and Beckman. We don't know how prevalent it is in our ICU as the article mentions, either. Since we don't have skin tear risk assessment tool and skin tear prevention protocol, our action tends to be reactive treating skin tear. Treating skin tear can be dependent on each nurse's clinical knowledge/experience. In addition to that, even if we try to prevent skin tear, we have a limited resource; a phlebotomist uses non-adhesive bandage after their draw blood, while the bandage is not available for us to use currently, for example. We are trained annually for safe patient handling, where we can review ways of minimizing friction and sheering on fragile skin. In addition to that training, our use of AirTap is very helpful to reduce friction and sheering compared to mere use of sheets for vertical/lateral transfer.
What are the advantages and disadvantages of implementing the article recommendations on your unit and/or hospital?
The most advantage of implementing a skin tear prevention intervention in our ICU is that we can prevent an incident of skin tear. The skin tear prevention intervention raises Nurses awareness driving us to be proactive by assessing at-risk patients first with the skin tear risk assessment tool and carry out Skin tear prevention protocol as the article did. Skin tear prevention bundle gives us our prevention technique standardized with resources such as skin prep before using adhesives, adhesive remover wipes, stockinette. Personally, I'd like to add 'Pain-Free wrap,' which is used by a phlebotomist after their blood draw, to our ICU Skin tear Prevention Bundle. The cost of prevention bundle in the article is less than $2, which is cost effective and easy to implement the bundle. Other advantage is that it can contribute to increase job satisfaction/retention since the protocol is Nurse-led initiatives which enhances our autonomy. Other advantage is that we already have an annual training of safe patient handling to review how to minimize friction and sheering forces.
Disadvantage would be that we cannot use their skin tear prevention intervention without revision since their setting is focus on endoscopic procedures, so their routine is different from ICU's. For example, ERCP is rather rare case in our ICU. We need to develop our own tool for our ICU.
Discuss the research question or main problem in the study:
ReplyDeleteThe study focused on endoscopy patients aged 65 and older who are at higher risk for skin tears due to fragile skin, chronic health conditions, and limited mobility. The researchers wanted to determine whether evidence-based skin tear prevention protocol could increase nurses' knowledge and reduce the number of skin tears in older endoscopy patients. The main question was whether
implementing a skin tear protocol can improve patient safety and to identify high risk patients to prevent avoidable skin injuries.
Discuss the sample size used in the study:
The study was conducted in the endoscopy department of a 27- bed community hospital in Scottsdale, Arizona. In 2022, the department treated 8.203 patients including 4,361 patients aged 65 years and older, who represented the population at higher risk for skin tears. The sample consisted of registered nurses with adult endoscopy patients who completed at least two of the three study questionnaires. The nurses had an average of 14.7 year of nursing experience. The education and experience levels of the endoscopy nurses included 55% BSN, 13.5 MSN, 13.5 ADN, and 18% Diploma.
ReplyDelete1). Discuss the research question or main problem discussed in the study?
The main problem the study tackles is an increase in skin tears among older endoscopy patients, who commonly have fragile skin and other risk factors, in a unit that had no formal screening or prevention process. The project asked whether creating and rolling out an endoscopy-specific prevention protocol—risk assessment plus a simple bundle of skin-prep wipes, limb coverings, safe handling, and adhesive removers—together with staff education, would improve nurses’ knowledge and lower tear rates. Over three months the team tracked protocol use, surveyed knowledge at three time points, and compared tear counts, reporting both a large gain in knowledge and a substantial drop in new tears.
2). What are the advantages and disadvantages to the proposed recommendations in the article?
The article recommends screening endoscopy patients with a skin-tear risk tool, using a low-cost bundle of prep and remover wipes, stockinette, and safe handling, applying it to all patients, documenting it in the EMR, and sustaining it with education, audits, and a champion. These steps increase nurse knowledge, appear to cut reported tears, cost little, and improve safety and staff autonomy. Limits include a small volunteer sample and self-reported tear data that may undercount events. Fit outside endoscopy is unproven, the extra work can burden nurses, and no formal cost-benefit analysis was done, so lasting impact remains uncertain.
1. Describe the method used by the author of the study.
ReplyDeleteThe authors used an evidence-based quality improvement project and feasibility study with a pre-test/post-test survey design. The study was conducted over three months in an endoscopy department. The researchers developed and implemented a skin tear prevention protocol and educated the nurses. The researchers measured nurses’ knowledge about skin tear prevention before the intervention, one month after, and three months after. The researchers also examined whether the prevention protocol reduced skin tears in patients. This method was appropriate because it allowed the researchers to compare the nurses’ knowledge before and after the education and determine whether the new prevention protocol was effective.
2. Discuss the sample size used in the study.
The study included 17 endoscopy nurses who completed at least two of the three questionnaires and were included in the results. During the 12-week study, 603 skin tear risk assessments were completed on patients aged 65 and older, and 537 patients were identified as being at risk for skin tears. The sample was useful for a small feasibility and quality improvement study, but it was still limited. The authors acknowledged that the small number of nurses and patients means that more research with larger samples is needed to confirm the findings.