Skin Tears: Adapting a Classification System into Clinical Practice

Poster Presentation

Thursday, 20 July 2006
10:00 AM - 10:30 AM
Thursday, 20 July 2006
3:00 PM - 3:30 PM

This presentation is part of : Poster Presentations II

Toni McTigue, APRN, BC, CWOCN and Janet Doyle-Munoz, RN, BSN, CWOCN. wound, ostomy, continence, Morristown Memorial Hospital, Morristown New Jersey, Morristown, NJ, USA

Learning Objective #1: establish a protocol for the care and management of skin tears in an acute care facility
Learning Objective #2: incorporate this Evidenced-Based Skin Tear protocol into nursing practice

A skin tear results from a complex series of age-related changes that prediposes the individual to mechanical stress and shear. Poor understanding of skin tears can lead to misdiagnosis and inappropriate care. A wound prevelence study of 328 patients revealed 6% were related to skin tears. A survey of nursing staff elicited a knowledge deficit. The literature review lacked evidence of established protocols or practice guidelines.

The Payne-Martin skin tear clasiffication system,established in the 1980's addresses the assessment, prevention and treatment of skin tears. This system offers nurses a clinical reference for skin tears. A skin tear protocol was developed to provide a framework for the prevention and management of skin tears. A skin tear education program for nursing staff was designed. A pre-test established baseline knowledge. Classes focused on prevention, assessment, classification and management of skin tears. A post-test provided feedback regarding understanding of skin tear concepts.

A protocol to address the appropriate prevention, assessment , and mangement of skin tears can be an effective strategy for teaching. Consistent care and management of skin tears can enhance patient comfort and improve quality of life for indviduals at risk.

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See more of The 17th International Nursing Research Congress Focusing on Evidence-Based Practice (19-22 July 2006)