1510 Reducing the Incidence of Skin Tears with Best Practices

Charlene A. Demers, GNP-BC, CWOCN, Orlando VA Medical Center, Clinical Nurse Specialist, Orlando, FL

In a 120 bed long term care facility during the period from January 2010 through June 2010 thirty-six residents (one third of the population) acquired skin tears.  Thirty-one percent of those residents with skin tears had sustained multiple skin tears during that time period. Seventy-five percent of the skin tears documented healed.   Therefore, concluding the nursing staff competency in healing skin tears but lacking in skills and techniques in preventing skin tears.

A multidisciplinary facility Skin Committee comprised of an ARNP/CWOCN, nurse manager, charge nurses, licensed nursing staff, nursing assistants, dietitian, physical therapist, and a supply chain representative initiated a performance improvement project for the purpose of  reducing the incidence of skin tears by 10% in one year.

Evidenced-based literature was reviewed while evaluating the current facility practices.  Areas investigated were: documentation of skin tear occurrence and cause, identifying residents at risk, prevention care plans for high risk residents, education of nursing staff on skin tear prevention, and quality of shower soap and moisturizers.

Performance improvement data collected one year following initiation of the skin tear prevention interventions showed during January 2012 through June 2012 forty-two facility residents acquired skin tears.  This was an increase from the 2010 data collected which may be attributed to an improved compliance with documentation of skin tears.  Although there was a reported increase in number of skin tears, only 12%  of those residents with skin tears developed multiple skin tears during that time period.   Thus a 61% reduction of  skin tear incidence in high risk residents.

In conclusion, implementation of evidenced-based best practices in skin tear prevention is shown to  reduce the number of facility acquired skin tears in residents at risk.