Symptoms And Treatment Of Skin Tears

Evidence suggests that pressure ulcers greatly increase mortality rates in both hospitals and nursing homes (Thomas, 2001). Patients who develop a pressure ulcer within six weeks of admission to an acute-care facility are three times more likely to die than patients who do not develop pressure ulcers (Thomas, 2001). Moreover, patients who develop a pressure ulcer within three months of admission to a long-term care facility are associated with a 92% mortality rate compared with a 4% mortality rate for patients who do not develop them (Thomas, 2001). This evidence alone shows how significant this problem is to the overall health status of patients. In my personal nursing experience, I have heard many complaints voiced from patients and their family members concerning the development of new pressure ulcers. Patients and family members have expressed dissatisfaction because of the increased stress and prolonged hospital stay often associated with the treatment of pressure ulcers.

A common health concern seen in the elderly, especially those within institutions, are pressure ulcers. A pressure ulcer is defined as a localized injury to the skin or underlying tissue that occurs when something keeps rubbing or pressing against the skin. Pressure on the skin causes a decrease of blood flow to that area and as a result, an ulcer may form because of the skin dying due to the lack of blood in that region. They generally occur over bony prominences such as, the buttock, elbow, hip, heel, back of the head and ankles. An ulcer has a greater chance of forming if the person uses a wheelchair or stays in bed for a long period of

Skin tears and pressure ulcers are frequently seen in the elderly and care home residents are prime candidates (Stephen-Haynes

A study conducted over seven years by Amir et al (2011) showed a significant decline of pressure ulcer development after three years of the study. This was partly due to strategies being implemented in regards to repositioning along with adequate nutrition, pressure ulcer prevention information leaflets were given to patients and skin assessments (Amir et al., 2011). It must also be considered that different patients will have different comorbidities and the use of a risk assessment tool is vital to assess and implementing a plan for pressure ulcer prevention according to the patient’s score (Tannen et al., 2010).

Thus, the expected outcome is that there is prevention of skin breakdown relating to pressure ulcers during hospitalizations for patients.

Skin integrity is an important concept that’s nurses assess on their patients. A key skill in nursing practice is to frequently assess the skin for possible breakdown or decreased skin integrity. Skin assessments should be conducted thoroughly once a shift and frequently reassessed for any signs of change. Skin discrepancies may be the first sign of an underlying issue. Early detection of any breakdown can help to implement interventions sooner. Unfortunately, unless there is a major skin discrepancy, skin issues can easily get overlooked, specifically in documentation and report. The focus of this paper is to research new skin integrity assessments to improve documentation effect and accuracy, resulting in decreased prevalence of skin breakdown in hospitalized patients. Topics discussed include reviewing current practices and new skin assessment techniques that decrease the prevalence of skin breakdown and pressure ulcers.

Pressure ulcers during a hospital admission are preventable. Assessment and early intervention can stop skin breakdown before it begins. Many factors regarding Mr. J’s condition placed him at a high risk regarding nursing indicators. Mild dementia, recent fall and a fractured hip all require a high level of nursing care and indicates preventative practice. Upon assessment, precautions should be in place to deter further complications. The elderly are more

While nurses encounter patients with pressure ulcers in home care and acute care settings, they are mainly a problem with elderly adults in long term care facilities. This is because of decreased sensory perception, decreased activity and mobility, skin moisture from incontinence, poor nutritional intake, and friction and shear (Stotts and Gunningberg, 2007).

As cited by Jarvis (2012, p.203), “the skin is the sentry that guards the body from environmental stresses and adapt it to other environmental influences.” Maintaining the elderly patient’s skin integrity requires a holistic care approach. As a nurse, one of our best practices is performing a thorough skin assessment of the whole body of our patients. A detailed head-to-toe skin assessment and clear documentation can help the interdisciplinary team in generating individualize plan of care. I perform a thorough assessment by inspecting the patient’s skin color, temperature, texture, moisture, and for presence of wounds. I ensure that the information I obtained from the skin inspection is clearly documented in the patient’s chart and plan of care, and any skin changes are communicated to the physician or nurse practitioner.

Despite advancement of technology, pressure ulcer continues to be a primordial in the health care system. Prevention of pressure ulcer remains an important issue in the health care facility. The critically ill ICU patient is the main target of this disease. Prevention remains the key for this problem. Some facility have standard policy for the eradication of pressure ulcer However the question is will the sacrum pressure ulcer formation be reduced in adult critically ill clients

According to the Agency for Healthcare Research and Quality (AHRQ), 2.5 million patients are affected by pressure ulcers and incur costs anywhere from $9.1 billion to $11.6 billion per year in the United States (AHRQ, 2014). As of October 1, 2008, the Centers for Medicare and Medicaid Services (CMS) will not reimburse hospitals for cases in which the pressure ulcer was acquired after admission (CMS, 2008). Because of this high cost, the number of patients affected each year, and insurances no longer reimbursing hospital acquired pressure ulcers (HAPU), an accurate skin assessment upon admission is critical to reduce costs, ease pain in patients, and lower incidences of pressure ulcers. This paper will address what leadership and management skills and functions are required of a wound care nurse who identifies a problem with the accuracy of skin assessments on newly admitted patients.

Pressure Ulcer is a breakdown of skin appears on the skin over a very thin or bony prominence

This article includes many peer review studies to see the trend of nursing care in relation to skin care and pressure ulcer prevention. It looks at quality of assessment, implement, and plan of care before and after admission.

(Soanes, 2003). Therefore, a risk assessment tool is a document produced to identify the hazards to self or others, the risks, how to control the risks, action to be done and the person responsible (see appendix 2). My chosen risk assessment tool is for skin. Skin is a broad term defined as the outer layer of a human body, consisting of an outer layer, the epidermis and the inner layer the dermis (Martin, 2014). The skin has three main functions, sensation, protection and regulation. As you grow older the skin changes, it becomes thinner and thinner. In this assignment, I will focus on the skin of vulnerable adult, Mrs Jones aged 87. I have changed names for confidentiality (NHS England, 2014). Elderly are prone to have dry skin due to the presence of one or more additional disease or disorders co-occurring with a primary disease or disorder which results in taking too many different medications (Todaysgeriatricmedicine.com, 2016). I have realised that if elders have dry skin, it is easily for them to bruise and have skin tears. In addition, the cause of skin fragility outside age related factors are immunological status, under nourishment, circulation and oxygen intake (Meuleneire, 2002).

In today’s world, elderlies suffering with ulcers are very common. Ulcers are sores that occurs on the external surface or internal surface of the body, which is caused by a break in the skin that does not fully recover or fail to heal. Ulcers come in different forms, targeting different areas, due to different reasons with some slight similarities to them.. People with ulcers has many treatment options, depending on their case, stage, and kind of ulcer, for example stasis and pressure ulcer. Stasis and pressure ulcer are two ulcers that has lack of blood flow as a factor why it occurs, even though it gives a different outcome for both ulcers.