The Prevalence of Skin Tears in One Acute Care Hospital

Purpose

A skin tear (ST) is a traumatic wound that is the result of friction and/or shearing forces that separate the epidermis from the dermis.³ The reported prevalence of STs in the acute care setting ranges from 6.2% to 11.4%.^1,2  The purpose of this quality improvement project was to determine the prevalence of STs at a Level 1 Trauma Center in the Midwestern United States.

Methods

The health system’s Institutional Review Board determined this project to be quality improvement and patient consent was not needed. ST prevalence data was collected concurrently with the quarterly Pressure Injury Prevalence Survey (PIPS) over a period of 12 months by the PIPS Skin Care Champions. During the survey, all adult, children, and neonate patients were assessed.  The patient’s skin was assessed from head to toe.  A data collection form developed by the WOC was filled out only for the patients with a ST/(s).  The data collected included the patient’s age, gender and whether the tear was hospital acquired.  Data was also collected regarding anatomical location, risk factors, and the classification of the tear.  The Payne-Martin Skin Tear Classification Tool was used with permission.

Outcomes
The prevalence of STs was 2.92% (46/1576 patients).  Seventy STs were found on 46 patients; 13 patients had multiple tears. Twenty-one patients were female and 25 males.  The age range was 8 days to 96 years with a mean age of 69.90 years. Fifty-one of the STs were located on the extremities.  Using the Payne-Martin Skin Tears Classification Tool, 31 tears were category III. Thirty patients were found to have hospital-acquired STs. Major risk factors included frail skin (n=34), advanced age (n=30), and impaired mobility (n=24).