Pressure injuries in people with darker skin tones: A literature review

Abstract

The current literature suggests a need for researchers and clinicians to consider skin tone variances rather than ethnicity when exploring comprehensive skin assessment.

Embedding skin tone diversity into undergraduate nurse education: Through the lens of pressure injury

“…From the data gathered across five Higher Education Institutions in England, limited inclusion of information around skin tone diversity relating to pressure injury was evident. There was no specific introduction of the risk factors for people with darker skin tones, or the fact damage may be more severe before detection occurs (Matas et al., 2001; Oozageer et al., 2017).…”

“…Both patient safety and diversity have been acknowledged as key priorities within nursing curricula (Bednarz, Schim, & Doorenbos, 2010; Tregunno, Ginsburg, Clarke, & Norton, 2014). Even so, it is acknowledged by Ginsburg, Castel, Tregunno, and Norton (2012) that student nurses are not fully informed of overall patient safety and diversity issues, particularly surrounding pressure injuries (Simonetti, Comparcinia, Flaccoa, Giovanni, & Cicoliniac, 2015) and, specifically, pressure injuries amongst people with darker skin tones (Oozageer Gunowa et al, 2017).…”

“…The use of these terms as sole indicators of early‐stage pressure injury creates a level of disparity in risk assessment for people with darker skin tones as these indicators may not be apparent in this group, even in the presence of pressure damage. Despite limited literature and guidance being available surrounding the topic of pressure injuries and skin tone diversity, it remains the responsibility of nurse educators to inform students of this lack of insight; by addressing contemporary issues and health disparity within the nursing curriculum, nurse educators enable students to consider care for all and identify people who are more at risk of developing more severe pressure injuries (Oozageer, Hutchinson, Brooke, & Jackson, 2017). Therefore, further exploration of nurse education content is required to help identify if and understand how the topic of pressure injuries and skin tone diversity is incorporated into student teaching and learning.…”

Technical rationality and the decentring of patients and care delivery: A critique of ‘unavoidable’ in the context of patient harm

“…Additional examination of the pressure injury exemplar provides evidence of marginalisation of particular patient groups due to perceptions of risk. In the field of pressure injury, the current strategies for skin assessment, for example, are largely premised on the assumption of whiteness, and so the needs of persons from Black and Minority Ethnic (BME) communities are not well served by current assessment measures (Oozageer Gunowa, Hutchinson, Brooke, & Jackson, in press). In the United States, analysing inpatient outcomes over a two‐year period, Duchman et al.…”

A unified call to action from Australian nursing and midwifery leaders: ensuring that Black lives matter

“…While nursing and midwifery produce documents such as curricula papers and mission statements claiming diversity and inclusivity, white is generally 'the norm' and this can be seen across educational and practice domains. Best (2018) drew attention to the 'whiteness' of nursing and midwifery and in practice, we see every day clinical activities, such as skin assessment also based on the assumption that everyone is Caucasian, meaning people of colour are more likely to develop higher stage pressure injuries (Oozageer Gunowa et al, 2018). When considering whiteness in the classroom, there is a need to contemplate white privilege as well as middle class privilege.…”