Enhanced Skin Assessment Methodology to Detect Early Tissue Damage and Prevent Pressure Injuries | JoVE Visualize

Area of Science:

Critical Care Medicine
Nursing Research
Biomedical Engineering

Background:

Pressure injuries (PIs) are a significant concern in critically ill patients, often linked to limitations in traditional skin assessment methods.
Existing assessment tools may not adequately identify early tissue damage, particularly in individuals with darker skin tones, potentially leading to disparities in care.
Subepidermal moisture (SEM) assessment technology offers a novel approach to evaluate tissue hydration and detect early signs of injury.

Purpose of the Study:

To evaluate the efficacy of subepidermal moisture (SEM) assessment in identifying and preventing pressure injuries (PIs) among critically ill adults.
To determine if SEM assessment can improve the accuracy of PI risk assessment and guide appropriate prevention strategies.
To explore the potential of SEM technology to address racial disparities in skin assessment and PI prevention.

Main Methods:

A retrospective, descriptive, comparative study involving 69 critically ill adults in a surgical trauma intensive care unit.
Collected demographic data, Braden Scale scores, SEM assessment results (sacral and heel delta), PI occurrence, and prevention interventions.
Conducted a web-based survey to assess nurses' perceptions of the SEM device's usability and accuracy.

Main Results:

A significant correlation was found between higher SEM delta scores and increased PI risk, with a negative correlation observed between Braden Scale scores and SEM delta.
Of patients with elevated sacral SEM delta, a substantial proportion did not receive appropriate PI prevention interventions.
Nurses reported the SEM device was easy to use and improved skin assessment accuracy, particularly for patients with darker skin tones.

Conclusions:

SEM technology demonstrates significant potential in enhancing the accuracy of pressure injury risk assessment in critically ill patients.
The use of SEM assessment can help mitigate racial disparities in skin assessment and promote more effective, location-specific PI prevention strategies.
Integrating SEM assessment into clinical practice may lead to improved patient outcomes by enabling earlier and more precise interventions.