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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)