1
|
LeBlanc K, Ousey K. Assessment, prevention and management of skin tears in older people. Nurs Older People 2024; 36:22-28. [PMID: 38919021 DOI: 10.7748/nop.2024.e1462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2024] [Indexed: 06/27/2024]
Abstract
Skin tears are common injuries that result from mechanical forces. Older people with fragile skin are at greater risk of this type of wound. They are usually categorised as acute wounds that typically heal in 7-21 days but the healing process can be disrupted, leading to chronic, non-healing wounds. They have the potential to compromise quality of life and disrupt daily activities, so it is important to identify risk factors and implement prevention strategies for those at risk. An interdisciplinary approach has a pivotal role in promptly and precisely identifying skin tears, and the use of evidence-based interventions for efficient skin damage management can enhance the recovery process. This article adopts a case study approach to explore the prevention, evaluation and treatment of skin tears, using the case of an individual living with a skin tear in a community setting.
Collapse
Affiliation(s)
- Kimberly LeBlanc
- Nurses Specialized in Wound, Ostomy and Continence Canada, Ottawa, ON, Canada
| | - Karen Ousey
- University of Huddersfield, Huddersfield, England
| |
Collapse
|
2
|
Völzer B, El Genedy-Kalyoncu M, Fastner A, Tomova-Simitchieva T, Neumann K, Hillmann K, Blume-Peytavi U, Hahnel E, Sill J, Balzer K, Kottner J. Enhancing skin health and safety in aged care (SKINCARE trial): A cluster-randomised pragmatic trial. Int J Nurs Stud 2024; 149:104627. [PMID: 37956524 DOI: 10.1016/j.ijnurstu.2023.104627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Older nursing home residents are prone to develop different skin conditions at the same time, including xerosis cutis, skin tears, pressure ulcers, incontinence-associated dermatitis or intertrigo. Guidelines and recommendations mainly address these skin conditions separately. The overall aim of this study was to measure the effects of the implementation of a skincare and prevention package. TRIAL DESIGN A two-arm cluster-randomised controlled trial was conducted. METHODS In nursing homes being assigned to the intervention group, an evidence-based and structured skincare and prevention programme was implemented for six months. Nursing home residents in the control group received standard care as usual. Blinded dermatologists conducted head-to-toe skin assessments, and the researchers assessed skin barrier parameters including stratum corneum hydration and transepidermal water loss at the upper and lower extremities after three and six months. Outcomes included the cumulative incidence of incontinence-associated dermatitis, skin tears, pressure ulcers and intertrigo, and were presented as intention-to-treat and per protocol analysis. Skin dryness and resident-reported outcomes (pain, itch, quality of life) were assessed. RESULTS A random sample of 17 nursing homes in the federal state of Berlin, Germany, was drawn and randomised in intervention (n = 9) and control groups (n = 8). In total, 165 participants were allocated to the intervention, and 149 participants were allocated to the control group. The cumulative incidence of skin tears (19.2 %, 95 % CI 12.8-27.8), pressure ulcers (13.6 %, 95 % CI 8.1-21.9) and intertrigo (27.0 %, 95 % CI 18.4-37.7) was lower in the intervention compared to the control group, with cumulative incidences of 27.2 % (95 % CI 19.3-36.9) for skin tears, 16.9 % (95 % CI 10.6-25.9) for pressure ulcer, and 37.8 % (95 % CI 27.5-49.4) for intertrigo. The incidence of incontinence-associated dermatitis was higher in the intervention group (26.3 %, 95 % CI 17.9-36.8) compared to the control group (23.1 %; 95 % CI 14.6-34.5). Mean skin dryness was lower in the intervention group but showed variation. The impact on pain, itch, and quality of life was trivial. CONCLUSIONS The present study results indicate that the implementation of tailored and evidence-based nursing routines improves skin health and safety in residential long-term care. Evidence suggests that multiple adverse skin conditions can be prevented by regular skin assessments and individually tailored skincare routines. Positive effects on skin dryness were observed, but skin physiology parameters did not indicate changes of the skin barrier function. TRIAL REGISTRATION This study is registered at the German Clinical Trials Register (registration number: DRKS00015680; date of registration: January 29th, 2019) and ClinicalTrials.gov (NCT03824886; date of registration: January 31st, 2019).
Collapse
Affiliation(s)
- Bettina Völzer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117 Berlin, Germany
| | - Monira El Genedy-Kalyoncu
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117 Berlin, Germany
| | - Alexandra Fastner
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117 Berlin, Germany
| | - Tsenka Tomova-Simitchieva
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Charitéplatz 1, 10117 Berlin, Germany
| | - Konrad Neumann
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Institute of Biometry and Clinical Epidemiology, Charitéplatz 1, 10117 Berlin, Germany
| | - Kathrin Hillmann
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Charitéplatz 1, 10117 Berlin, Germany
| | - Ulrike Blume-Peytavi
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Charitéplatz 1, 10117 Berlin, Germany
| | - Elisabeth Hahnel
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Charitéplatz 1, 10117 Berlin, Germany
| | - Janna Sill
- University of Lübeck, Nursing Research Unit, Institute for Social Medicine and Epidemiology, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Katrin Balzer
- University of Lübeck, Nursing Research Unit, Institute for Social Medicine and Epidemiology, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Jan Kottner
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117 Berlin, Germany; Ghent University, Faculty of Medicine and Health Sciences, Belgium.
| |
Collapse
|
3
|
Fastner A, Hauss A, Kottner J. Skin assessments and interventions for maintaining skin integrity in nursing practice: An umbrella review. Int J Nurs Stud 2023; 143:104495. [PMID: 37099847 DOI: 10.1016/j.ijnurstu.2023.104495] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 03/29/2023] [Accepted: 03/30/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND Daily skin care routines are fundamental aspects of clinical nursing practice. Providing skin care, including skin cleansing and application of leave-on products have substantial impact on the prevention and treatment of a number of skin conditions. There are hundreds of individual studies about skin risks, classifications, skin conditions, prevention and treatment. OBJECTIVE To summarise the overall evidence regarding 1) risk factors associated with xerosis cutis, incontinence-associated dermatitis/diaper dermatitis, intertrigo, skin tears, 2) the performance of diagnostic tests and/or classifications addressing the severity and/or signs and symptoms of xerosis cutis, incontinence-associated dermatitis/diaper dermatitis, intertrigo, skin tears, 3) the effects of skin cleansing/care interventions for the maintenance and promotion of skin integrity in all age groups, 4) effects of skin cleansing/care interventions for the prevention of xerosis cutis, incontinence-associated dermatitis/diaper dermatitis, intertrigo, skin tears in all age groups. DESIGN Umbrella review. DATA SOURCES A systematic search in MEDLINE and Embase (via OvidSP), Cochrane and Epistemonikos was conducted. Reference lists and experts were consulted for potentially missed reviews. REVIEW METHODS Two reviewers screened titles/abstracts and full-texts independently. After rating the risk of bias only low to high overall confidence (AMSTAR 2) and low risk of bias (ROBIS) reviews were included. RESULTS Twelve systematic reviews were included. Due to substantial heterogeneity regarding study designs, methods, and outcomes all authors presented findings in a narrative synthesis. The validity and reliability of the International Skin Tear Advisory Panel classification is supported by moderate quality evidence, and the reliability and criterion validity for Skin Tear Audit Research were rated insufficient. Overall, review results indicate that structured skin care programs are preferable to unstructured skin care with classic soap and water for maintaining skin integrity in general, preventing skin tears, and to prevent and treat xerosis cutis and incontinence-associated dermatitis. All reviews focusing on leave-on products for the prevention and treatment of incontinence-associated dermatitis and diaper dermatitis indicate the effectiveness of barrier films or lipophilic leave-on products in adults, elderly people and paediatric care, but could not establish the superiority of any product. CONCLUSIONS The majority of systematic reviews in the field of skin care is at high risk of bias and should not be used for evidence-based practice. Overall, evidence indicates, that structured skin care programs containing low-irritating cleansers and application of leave-on products are beneficial to maintain skin integrity and prevent skin damage across a wide range of different skin conditions across the life span.
Collapse
|
4
|
Völzer B, El Genedy-Kalyoncu M, Fastner A, Tomova-Simitchieva T, Neumann K, Sill J, Balzer K, Kottner J. Prevalence and associations of xerosis cutis, incontinence-associated dermatitis, skin tears, pressure ulcers, and intertrigo in aged nursing home residents: A representative prevalence study. Int J Nurs Stud 2023; 141:104472. [PMID: 36898269 DOI: 10.1016/j.ijnurstu.2023.104472] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 01/27/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND The number of elderly and care-dependent people is increasing, leading to increased risks of adverse skin conditions. Skin care, including prevention and treatment of vulnerable skin, is an essential part of daily nursing practice in long-term residential settings. For many years, the research focus has been on individual skin problems including xerosis cutis, incontinence-associated dermatitis, skin tears, pressure ulcers, and intertrigo, although people may be affected by several at the same time. OBJECTIVES Aim of the present study was to describe the prevalence and associations of skin conditions relevant to nursing practice in aged nursing home residents. DESIGN Analysis of baseline data of a cluster-RCT in long-term residential settings. SETTING The study was conducted in a representative sample of n = 17 nursing homes in the federal state of Berlin, Germany. PARTICIPANTS Care dependent nursing home residents being 65+ years. METHODS A random sample of all eligible nursing homes was drawn. Demographic and health characteristics were collected and head-to-toe skin examinations conducted by dermatologists. Prevalence estimates and intracluster correlation coefficients were calculated, and group comparisons conducted. RESULTS Three hundred fourteen residents with a mean age of 85.4 (SD 7.1) years were included. The majority was affected by xerosis cutis (95.9%, 95% CI 93.6 to 97.8), followed by intertrigo 35.0% (95% CI 30.0 to 40.1), incontinence-associated dermatitis 21.0% (95% CI 15.6 to 26.3), skin tears 10.5% (95% CI 7.3 to 13.8), and pressure ulcers 8.0% (95% CI 5.1 to 10.8). In total, more than half of the nursing home residents were affected by two or more skin conditions at the same time. Several associations between skin conditions and mobility, care dependency, or cognitive impairment were observed. There were no associations between xerosis cutis, incontinence-associated dermatitis, skin tears, pressure ulcers or intertrigo. CONCLUSIONS The adverse skin and tissue conditions xerosis cutis, incontinence-associated dermatitis, skin tears, pressure ulcers and intertrigo are very common in long-term residential settings, placing a high burden on this population. Although care receivers share similar risk factors and may be affected by several skin conditions at the same time, there are no associations indicating separate aetiological pathways. REGISTRATION This study is registered at the German Clinical Trials Register (registration number: DRKS00015680; date of registration: January 29th, 2019) and ClinicalTrials.gov (NCT03824886; date of registration: January 31st, 2019).
Collapse
Affiliation(s)
- Bettina Völzer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117 Berlin, Germany
| | - Monira El Genedy-Kalyoncu
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117 Berlin, Germany
| | - Alexandra Fastner
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117 Berlin, Germany
| | - Tsenka Tomova-Simitchieva
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Department of Dermatology and Allergy, Charitéplatz 1, 10117 Berlin, Germany
| | - Konrad Neumann
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Institute of Biometry and Clinical Epidemiology, Charitéplatz 1, 10117 Berlin, Germany
| | - Janna Sill
- University of Lübeck, Nursing Research Unit, Institute for Social Medicine and Epidemiology, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Katrin Balzer
- University of Lübeck, Nursing Research Unit, Institute for Social Medicine and Epidemiology, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Jan Kottner
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117 Berlin, Germany; Ghent University, Faculty of Medicine and Health Sciences, Belgium.
| |
Collapse
|
5
|
Cilluffo S, Bassola B, Beeckman D, Lusignani M. Risk of skin tears associated with nursing interventions: A systematic review. J Tissue Viability 2023; 32:120-129. [PMID: 36577638 DOI: 10.1016/j.jtv.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 10/08/2022] [Accepted: 11/27/2022] [Indexed: 12/07/2022]
Abstract
BACKGROUND Skin tears are a significant problem for patients and healthcare professionals. They can cause pain, impact quality of life, and become chronic and infected. The risk of skin tears is associated with dependence in daily life activities and with nursing interventions. OBJECTIVES To examine which nursing interventions increase the risk of skin tears. DESIGN Systematic review. DATA SOURCES The MEDLINE, CINAHL, Scopus, and Cochrane Library databases were searched in March 2022. PUBLICATION YEARS Publications included were from 2012 to 2022. RESULTS Seventeen articles were included in the final analysis reporting nursing interventions associated with the risk of skin tears. Hygiene with cold water and soap, not applying leave-on products to moisten/protect dehydrated skin, and wearing short sleeves were found to be associated with skin tears. Transferring patients into and out of bed in a rough manner and wearing jewelry or long nails can increase the risk of skin tears. Removal of adhesive dressings or bandages can also cause skin tears. CONCLUSION Nursing staff need to know which interventions put their patients at risk of skin tears and which interventions are recommended to prevent skin tears. Nursing care can affect the health of the patient's skin.
Collapse
Affiliation(s)
- Silvia Cilluffo
- School of Nursing, University of Milan, ASST GOM Niguarda, Milan, Italy; Department Biomedicine and Prevention, University of Rome, Tor Vergata, Rome, Italy.
| | - Barbara Bassola
- School of Nursing, University of Milan, ASST GOM Niguarda, Milan, Italy
| | - Dimitri Beeckman
- Faculty of Medicine and Health, School of Health Sciences, Nursing Science Unit, Swedish Centre for Skin and Wound Research, Örebro University, Sweden; Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Belgium
| | - Maura Lusignani
- School of Nursing, University of Milan, ASST GOM Niguarda, Milan, Italy; Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| |
Collapse
|
6
|
Feng L, Hu C, Li J, Ying Y, Chen L, Wei H, Liang H, Hu H. The Chinese version of the skin tear knowledge assessment instrument (OASES): Cultural adaptation and validation. J Tissue Viability 2023; 32:107-113. [PMID: 36543636 DOI: 10.1016/j.jtv.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 12/09/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Skin tear knowledge is an important predictor of the decreased incidence and management of skin tears, and the knowledge level among Chinese nurses is unknown so far. A validated instrument for measuring skin tear knowledge is urgent. OBJECTIVE To culturally adapt the skin tear knowledge assessment instrument (OASES) into Chinese and verify its validity and reliability in the Chinese context. METHODS The cultural adaptation process for OASES into Chinese was established on Beaton's translation model. Content validity was determined by the 8-expert group in wound care. A nationwide psychometric validation study was performed on a convenience sample of 3333 nurses from 113 tertiary hospitals, of whom 98 nurses finished the test-retest procedure for reliability analysis. Item validity (item difficulty and discriminating index) and construct validity (known-groups technique) were tested. RESULTS The content validity index was 0.88-1.00. The item validity was as follows: Item difficulty ranged from 0.16 to 0.86, with an average value of 0.52; the discriminating index varied between 0.05 and 0.61. The known-group technique demonstrated excellent construct validity with a significant difference between predefined groups with theoretically expected higher knowledge scores and theoretically expected lower knowledge scores (P < 0.001). For the test-retest reliability, the Intraclass correction coefficient (ICC) during a 14-day interval for the overall tool was 0.79 (95% CI = 0.71-0.86), and Cohen's kappa value for each item varied from 0.17 to 0.62. CONCLUSIONS The Chinese version of OASES was validated to be suitable for skin tear knowledge assessment with acceptable psychometric properties, through which the knowledge and training priorities of skin tear among Chinese nurses can be quantified.
Collapse
Affiliation(s)
- Liuqun Feng
- Nursing Department, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chen Hu
- Nursing Department, School of Medicine, Zhejiang University, Hangzhou, China
| | - Juyun Li
- Department of Nursing, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Yuai Ying
- Nursing Department, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lanpeng Chen
- Kangda College of Nanjing Medical University, Lianyungang, China
| | - Huiyan Wei
- Nursing Department, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hongyan Liang
- Nursing Department, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hongyang Hu
- Nursing Department, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
| |
Collapse
|
7
|
Al Khaleefa N, Moore Z, Avsar P, Connor TO, Budri A, Nugent L, Patton D. What is the impact of skincare bundles on the development of skin tears in older adults? A systematic review. Int J Older People Nurs 2022; 17:e12455. [PMID: 35212180 DOI: 10.1111/opn.12455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/13/2022] [Accepted: 02/03/2022] [Indexed: 11/28/2022]
Abstract
AIM This review explores the impact of skincare bundles on the development of skin tears in older adults (≥65 years). METHOD A systematic search of publications using MEDLINE, CINAHL and Cochrane databases was conducted in July 2020. The evidence-based librarianship (EBL) checklist assessed the methodological quality of the included studies. Data were extracted using a pre-designed extraction tool, and a narrative analysis was undertaken. RESULTS Following the search, 71 records were returned, with seven satisfying the inclusion criteria. The studies were conducted between 2003 and 2015, and 57% (n = 4) of these employed a pre-post study design. The mean sample size was 155 participants (SD = ±117.6). All the included studies (100%, n = 8) identified that there was a direct relationship between the use of skincare bundles and the reduction in the incidence of skin tears in the elderly. The EBL scores varied between 65% and 91%. In total, 85.7% (n = 6) of the studies scored ≥75%, reflecting validity. CONCLUSION This systematic review highlights the connection between skincare bundles and the reduction of the number of skin tears in the older population (≥65 years). Further research with larger sample sizes and longer study duration to validate these findings, which will provide a comprehensive insight into the prevention of the incidence of skin tears. Further studies are justified given that skin tear bundles can reduce the rate of injuries that are easily acquired by the elderly due to the nature of their frail skin, they also can help prevent skin tears from turning into chronic wounds and can decrease hospital admissions associated with hospital-acquired infections.
Collapse
Affiliation(s)
- Noor Al Khaleefa
- School of Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Zena Moore
- Skin Wounds and Trauma Research Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,School of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Fakeeh College of Health Sciences, Jeddah, Saudi Arabia.,School of Nursing and Midwifery, Griffith University, Queensland, Australia.,Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia.,Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Lida Institute, Shanghai, China.,University of Wales, Cardiff, UK.,National Health and Medical Research Council Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Queensland, Australia
| | - Pinar Avsar
- Skin Wounds and Trauma Research Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,School of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Tom O Connor
- Skin Wounds and Trauma Research Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,School of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Fakeeh College of Health Sciences, Jeddah, Saudi Arabia.,School of Nursing and Midwifery, Griffith University, Queensland, Australia.,Lida Institute, Shanghai, China
| | - Aglecia Budri
- Skin Wounds and Trauma Research Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,School of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Linda Nugent
- Skin Wounds and Trauma Research Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,School of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Declan Patton
- Skin Wounds and Trauma Research Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,School of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland.,Fakeeh College of Health Sciences, Jeddah, Saudi Arabia.,School of Nursing and Midwifery, Griffith University, Queensland, Australia.,Faculty of Science, Medicine and Health, University of Wollongong, New South Wales, Australia
| |
Collapse
|
8
|
Risk scoring tool for forearm skin tears in Japanese older adults: A prospective cohort study. J Tissue Viability 2021; 30:155-160. [PMID: 33741206 DOI: 10.1016/j.jtv.2021.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 02/09/2021] [Accepted: 02/24/2021] [Indexed: 11/21/2022]
Abstract
[Aim] Because painful skin tears frequently occur in older patients, the prevention of skin tears is fundamental to improve their quality of life. However, a risk assessment tool for skin tears has not been established yet in Japan. Therefore, we aimed to propose a risk scoring tool for skin tears in Japanese older adult. [Methods] We conducted a prospective cohort study with 6-month follow-up in two long-term care hospitals in Japan. A total of 257 inpatients were recruited. Patient and skin characteristics were collected at baseline, and the occurrence of forearm skin tears were examined during follow-up. To develop a risk scoring tool, we identified risk factors, and converted their coefficients estimated in the multiple logistic regression analysis into simplified scores. The predictive accuracy of the total score was evaluated. [Results] Of 244 participants, 29 developed forearm skin tears during the follow-up period, a cumulative incidence of 13.5%. Senile purpura, pseudoscar, contracture, and dry skin were identified as risk factors for skin tears. Their weighted scores were 6, 4, 5, and 6, respectively. The area under the receiver operating characteristic curve of the total score was 0.806. At a cut-off score of 12, the sensitivity was 0.86, and the specificity was 0.67. [Conclusion] Our forearm skin tear risk scoring tool showed high accuracy, whereas specificity was low. This tool can contribute to prevent forearm skin tears in Japanese older adults.
Collapse
|