Skin Tear Risk Reduction Program

Risk Factor Individual Caregiver/Provider
General Health
  • Educate patient on skin tear prevention and promote active involvement in treatment decisions (if cognitive function not impaired)
  • Optimize nutrition and hydration
  • Safe patient environment
  • Educate client +/circle of care/caregivers
  • Protect from self-harm
  • Dietary consult if indicated
  • Extra caution with extremes of body mass index (<20 or >30 kg/m2)
  • Review polypharmacy for medication reduction/optimization
Mobility
  • Encourage active involvement if physical function not impaired
  • Appropriate selection and use of assistive devices
  • Daily skin assessment and monitor for skin tears
  • Ensure safe patient handing techniques/equipment and environment (trauma, ADLs, self-injury)
  • Proper transferring/re-positioning
  • initiate fall prevention program
  • Remove Clutter
  • Ensure proper lighting
  • Pad equipment/furniture (bed rails, wheelchair, etc.)
  • Avoid sharp fingernails/jewelry with patient contact
Skin
  • Awareness of medication-induced skin fragility (eg. topical and systemic steroids)
  • Wear protective clothing (shin guards, long sleeves, etc.)
  • Moisturize skin (lubrication and hydration)
  • Keep fingernails short
  • Individualize skin hygiene (warm, tepid, not hot water; soap-less or pH-neutral cleaners; moisturize skin)
  • Avoid strong adhesives, dressings, tapes
  • Avoid sharp fingernails/jewelry with patient contact
Healthcare setting
  • Implement a comprehensive skin tear reduction program
  • Include skin tears in audit programs
  • Utilize validated classification system
  • Develop consultation team (would care/dietary specialists, rehab/pharmacists)