Skin Tears

Yy Margaret Heale, RN, MSc, CWOCN Hi blog buddies, Matron Marley here. I may be an ex-matron, but I may just have some gems for you. Today I would like to cast the threads (strings even) of time back to when I was a new nurse rather than a matron. The reason being the change happened then. I remembered it today when a rather frail lady caught her arm on a door mechanism. It tore such a huge triangle of her delicate skin, and my goodness did it bleed. I put on the gloves I keep in my pocket and pressed several napkins on it while the nurse went for supplies. She returned promptly with gloves, hand gel, gauze, skin prep, saline, cotton swabs, Xeroform, net and Steri-Strips™ (great invention, right up there with Velcro and cyanoacrylate).

Holly M. Hovan MSN, APRN, ACNS-BC, CWOCN-AP Payne and Martin brought skin tears to the attention of wound and skin specialists and to the wound care community when they reported an incidence rate of 2.23% in individuals aged 55 years and older, living in a long-term care facility. A skin tear is "a wound caused by shear, friction, and/or blunt force resulting in a separation of skin layers." Skin tears may be partial- or full-thickness wounds, develop into chronic wounds without proper treatment and follow-up, and, most importantly, are preventable.

My approach to wound care education with patients, providers, and nursing staff the last 20+ years has always been to make learning fun while emphasizing that wounds are a serious topic. My strong passion drives me to motivate anyone and everyone who wants to learn. If they don’t want to learn, then I’ll figure out the best way to motivate them! Everyone learns differently; however, hands-on training with added fun usually wins. Education should be ongoing and engaging, and it should create fun ways to experience more of those “aha” moments. We want to impact that long-term memory storage! Every care setting has variances, but my blog will provide you with some ideas that you can alter to fit your needs.

By Holly Hovan MSN, APRN, ACNS-BC, CWON-AP As a wound, ostomy, and continence nurse in long-term care, education is a huge part of my role working in our Community Living Center (CLC), Hospice, and Transitional Care Unit (TCU). Unit specific, evidence-based training and continued follow-up are integral to the success of our pressure injury prevention program. The unit-based skin care nurses (UBSCNs) are at the frontline of prevention, along with all nursing staff, especially nursing assistants (NAs).

As a response to increasing rates of infection with the novel coronavirus (which causes an illness termedCOVID-19), the Centers for Disease Control and Prevention and all major medical organizations are advising individuals to wash their hands thoroughly and frequently and for at least 20 seconds. This step will likely make a tremendous impact on mitigating the spread of COVID-19. Although we don’t have current and available data on how effective hand washing will be to stop this specific virus, we do have extensive accurate and reliable data on how much hand washing can reduce the potential transmission of infection. One study found that proper hand washing cut the risk of respiratory infection by 16%, and a subsequent study demonstrated a 21% reduction in transmission.

by Holly Hovan MSN, RN-BC, APRN, ACNS-BC, CWOCN-AP As discussed in a prior blog, stoma location is certainly one of the key factors in successful ostomy management and independence with care at home. However, even with proper stoma siting, peristomal skin complications may occur for a variety of reasons. In this blog I discuss a few of the more common peristomal skin complications and tips for management.