Preventing skin tears in a nursing and rehabilitation center: an interdisciplinary effort

Skin tears are painful, traumatic wounds that result from the separation of the epidermis from the dermis. To assess the clinical effectiveness of a preventive skin care protocol, 13-month retrospective pre-intervention data collection followed by 15-month post-intervention skin tear incidence data collection was conducted among all patients in a 209-bed urban nursing and rehabilitation center. The preventive skin care strategies implemented - staff education, skin sleeves and padded side rails for high-risk patients, gentle skin cleansers, and lotion - were selected by facility staff members and the multidisciplinary skin team. Nosocomial skin tear data were obtained by reviewing incident reports. Following implementation of the prevention protocols, the number of skin tears changed from a mean of 18.7 to a mean of 8.73 per month (P <0.001). The average monthly reduction in nosocomial skin tears was projected to reduce the dressing and labor costs of managing these wounds an average of 1,698 dollars per month (18,168.60 dollars annually). The results of this study confirm previously reported research suggesting that the effects of implementing a comprehensive skin care protocol can persist, reducing the incidence of nosocomial skin tears and their associated risks and costs. Prospective cost-effectiveness studies to confirm these findings are needed.