Australian National University, RCNMP Medical School, Canberra Canberra Hospital, Surgical Department, Garran, Australia.
Int J Evid Based Healthc. 2011 Dec;9(4):429-34. doi: 10.1111/j.1744-1609.2011.00234.x.
A skin tear is a traumatic wound that results from the separation of the skin layers due to shearing forces, friction or blunt trauma that affects all people. Numerous preventative measures aim to reduce the skin tears and minimise conditions that predispose the epidermis to injury. With the increasing elderly population in acute aged care, implementation of an evidence-based guideline is critical as changes to ageing skin integrity make this population more susceptible to skin tear.
AIMS/OBJECTIVES: The aim of this project was to ensure the practice of skin tear assessment, prevention and management among acute aged care causes and rehabilitation patients was performed according to best available evidence.
This project utilised a pre- and post-implementation audit design using the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice programs. The project was conducted from June to November 2010 with the audits conducted in the acute aged care and rehabilitation units of two public hospitals in the Australian Capital Territory involving a sample size of 96 patients at pre-audit and 95 patient at post-audit admitted during the audit period. A convenience sample of 20 nurses also consented to be observed. The audits were conducted after obtaining ethics approval and consent from patients and nurses.
The results showed a significant change in compliance to the skin tear guidelines at post-implementation audit. Staff education in particular had a dramatic increase from 20% to 98% and the point prevalence rate of hospital-acquired skin tear decreased from 10% to 0.15%.
DISCUSSION/CONCLUSION: This project emphasised the importance of education of all personnel involved in patient care and that a simple assessment of skin integrity is critical in preventing and managing skin tear especially among the susceptible elderly population.
皮肤撕裂是一种创伤性伤口，由于剪切力、摩擦力或钝器伤导致皮肤层分离而产生，影响所有人。有许多预防措施旨在减少皮肤撕裂，并尽量减少使表皮容易受伤的情况。随着急性老年护理中老年人人口的增加，实施基于证据的指南至关重要，因为衰老皮肤完整性的变化使这一人群更容易发生皮肤撕裂。
目的/目标：本项目的目的是确保在急性老年护理和康复患者中，根据最佳现有证据进行皮肤撕裂评估、预防和管理。
本项目采用预前后实施审计设计，使用 Joanna Briggs 研究所临床证据系统实用应用和将研究转化为实践计划。该项目于 2010 年 6 月至 11 月进行，在澳大利亚首都领地的两家公立医院的急性老年护理和康复病房进行了审计，涉及预审计时的 96 名患者和审计期间的 95 名患者，样本量为 96 名患者。还同意观察 20 名护士的方便样本。在获得患者和护士的伦理批准和同意后进行了审计。
结果显示，在实施后审计中，对皮肤撕裂指南的依从性有了显著变化。特别是员工教育从 20%急剧增加到 98%，医院获得性皮肤撕裂的点患病率从 10%下降到 0.15%。
讨论/结论：该项目强调了对所有参与患者护理的人员进行教育的重要性，特别是对易受影响的老年人群体，简单的皮肤完整性评估对于预防和管理皮肤撕裂至关重要。
