PREVENTION & TREATMENT
Clinical skincare with nurturing botanicals can help prevent skin tears.
Maintaining skin integrity is vital, particularly in high risk patients. Due to the fragility of their skin, people of age extremes as well as those who are critically or chronically ill tend to be more prone to skin tears. In the United States long-term care population, retrospective prevalence studies report skin tear rates ranging from 16% to 33%.1-4
This trial focuses on a 60-bed skilled nursing facility (50 beds traditional long-term care and 10 beds skilled/rehab unit) that was experiencing a high incidence of skin tears. The facility had been using a generic brand shampoo/body wash and lotion, but were having little compliance with getting product to patient and ensuring single patient use. But even when the products were used consistently, the skin did not appear to be well hydrated. At one point, the facility had over 30 skin tears with 5 being reoccurring on the same patients.
A clinical skin care line* with nurturing botanicals was evaluated. This skin care line is a combination of the most advanced skincare science with some of the gentlest, most beneficial botanicals that nature provides, resulting in a complete regimen of skincare specifically formulated for use on sensitive skin. A three month trial was initiated with the shampoo/body wash and moisturizing lotion to evaluate the effect on the skin tear rate.
A three-month trial from March 2017 through May 2017 was completed at the 60-bed skilled nursing facility with a 10-bed skilled unit. At the start of the trial, 18 patients had 32 skin tears.
Prior to implementation, the staff was in-serviced and monitored by the wound care nurse. The staff utilized individual packets of the moisturizing lotion after scheduled showers/baths with the shampoo/body wash. All other products were removed from the facility. Sachets were provided to clean linen rooms in bins, and wall pumps containing each product were instituted in shower rooms.
The impact of botanicals on skin health.
Cassandra Quave, PhD
Overall, (with an average census of 58 patients) the number of skin tears decreased by 50% compared to the previous 3 months— initially from 18 patients with 32 skin tears to 8 patients with 16 skin tears. After 6 months, there was a continued decrease of 25%. The number of skin tears decreased to 10% over one year of use from March 2017 to March 2018.
A decrease in healing times from 12-15 days on average to 9 days on average was also noted. Staff compliance improved due to easier access to product, in-servicing and consistent follow up. The staff further noted the ease of access, ease of application and the pleasant smell of the products.
By Christy Recke, a wound care nurse consultant for Skin Health at Medline Industries.
- Bank D, Nix D. Preventing skin tears in a nursing and rehabilitation center: an interdisciplinary effort. Ostomy Wound Manage. 2006; 52(9): 38-40.
- Birch S, Coggins T. No-rinse, one-step bed bath: The effects on the occurrence of skin tears in a long-term care setting. Ostomy Wound Manage. 2003; 49(1): 64-67.
- Demeres C. Reducing the incidence of skin tears with best practices. Ann Conf Wound Ostomy Continence Soc. 2013; 40(S1): S30.
- White MW, Karam S, Cowell B. Skin tears in frail elders: a practical approach to prevention. GeriatrNurs. 1994; 15(2): 95- 99.
*Remedy Phytoplex Nourishing Skin Cream, Remedy Phytoplex Hydrating Cleanser Shampoo and Body Wash