Skin tear prevalence in an Australian acute care hospital: A 10‐year analysis

Abstract

Hospital-acquired skin tear prevalence is under-reported; thus, the aim of this study was to analyse skin tear point prevalence and characteristics in a tertiary acute care hospital in Queensland, Australia, over a 10-year period. All consenting adult inpatients received a full skin inspection and skin tear category, site, cause, treatment, and whether it was documented as hospital-or community-acquired were recorded. Eleven prevalence audits were analysed with a total sample of 3626 patients. An overall pooled prevalence of 8.9% (95% confidence interval [CI] 7.5-10.4) with an associated hospital-acquired pooled prevalence of 5.5% (95% CI 4.5-6.7) was found. In total, 616 skin tears were reported, of which 374 (60.7%) were hospital-acquired. Over a third of patients (38.7%) had multiple skin tears and most patients (84.8%) with at least one skin tear were aged ≥70 years. The largest proportion of skin tears (40.1%) was those with no skin flap. Of those documented, most were caused by falls or collisions, suggesting combined skin tear and falls prevention strategies may be effective. Over a decade, there was a downward trend in hospitalacquired skin tear, which is encouraging. Skin tear prevalence is recommended as a measure of care quality with an emphasis on good quality documentation.

Use of a Sacral Foam Dressing to Prevent Pressure Injury in At-Risk Subacute Hospitalized Older Adults

“…Two of the identified PIs were found in the intervention group, but 1 of the PIs was disputed by an interrater reliability assessor 42. Similar to the conjecture of Walker and colleagues,42 we postulate that the low incidence in our study was attributable to a significant focus on PI prevention in the study hospital 28,37. Nevertheless, Walker and colleagues42 evaluated a different sacral dressing from that used in our study, and evidence should not be extrapolated across different dressing types and brands given variations in structure and composition 22.…”

“…Patients who met the following criteria were excluded: preexisting sacral PI; sacral region skin disease; trauma or other injury; incontinence-associated dermatitis; allergy to adhesive; or previous recruitment and participation within this pilot study. Based on hospital data suggesting that the PI incidence may be low,28 a relatively large pilot sample size of more than 120 was targeted, which was in line with sample size recommendations for a binary outcome external pilot RCT 29…”

Determination of Nurses’ Knowledge Levels on Skin Tears: A Cross-sectional Study

“…A majority of nurses in this study answered four of the six questions related to ST prevention incorrectly, and almost half of them incorrectly answered one of the prevention questions. Considering that more than half of STs observed in hospitalized patients are hospital-acquired, it is very important that nurses know about ST prevention 11 …”

“…Considering that more than half of STs observed in hospitalized patients are hospital-acquired, it is very important that nurses know about ST prevention. 11 Additional factors associated with nurses' ST knowledge scores included whether they had a graduate nursing degree, their years of nursing work experience, their unit, and whether they cared for patients with STs. Nurses manage their clinical practices with information they obtain from different sources, such as empirical, aesthetic, personal, and tacit knowledge.…”

“…5 Although STs occur in all healthcare settings, the prevalence varies by setting. 3 According to the literature, the prevalence of STs is 3.3% to 19.8% in acute care, [7][8][9][10][11] 5.0% to 19.5% in community care, 12,13 and 9.0% to 22.0% in long-term care. 5,[14][15][16] In addition to having negative effects on the individual, STs can also negatively impact the healthcare system and increase care costs.…”