The skin safety model: Reconceptualizing skin vulnerability in older patients
Purpose: To develop a unique skin safety model (SSM) that offers a new and uniﬁed perspective on the diverse yet interconnected antecedents that contribute to a spectrum of potential iatrogenic skin injuries in older hospitalized adults.
Organizing Construct: Discussion paper.
Methods: A literature search of electronic databases was conducted for published articles written in English addressing skin integrity and iatrogenic skin injury in elderly hospital patients between 1960 and 2014.
Findings: There is a multiplicity of literature outlining the etiology, prevention, and management of speciﬁc iatrogenic skin injuries. Complex and interrelated factors contribute to iatrogenic skin injury in the older adult, including multiple comorbidities, factors inﬂuencing healthcare delivery, and acute situational stressors. A range of injuries can result when these factors are com- plicated by skin irritants, pressure, shear, or friction; however, despite skin injuries sharing multiple ntecedents, no uniﬁed overarching skin safety conceptual model has been published.
Conclusions: The SSM presented in this article offers a new, uniﬁed framework that encompasses the spectrum of antecedents to skin vulnerability as well as the spectrum of iatrogenic skin injuries that may be sustained by older acute care patients. Current skin integrity frameworks address prevention and management of speciﬁc skin injuries. In contrast, the SSM recognizes the complex interplay of patient and system factors that may result in a range of iatrogenic skin injuries. Skin safety is reconceptualized into a single model that has the potential for application at the individual patient level, as well as health-care systems and governance levels.
Clinical Relevance: Skin safety is concerned with keeping skin safe from any iatrogenic skin injury, and remains an ongoing challenge for healthcare providers. A conceptual framework that encompasses all of the factors that may contribute to a range of iatrogenic skin injuries is essential, and guides the clinician in maintaining skin integrity in the vulnerable older patient.
Impact and interest:
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|Item Type:||Journal Article|
|Keywords:||incontinence-associated dermatitis, skin safety model, acute care, elderly, nursing|
|Divisions:||Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
|Copyright Owner:||Copyright 2015 Sigma Theta Tau International|
|Deposited On:||26 Apr 2016 02:53|
|Last Modified:||27 Apr 2016 00:41|
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