The Prevalence of Skin Tears in an Acute Care Hospital
Bibliographic record
Abstract
PURPOSE: The purpose of this quality improvement project was to determine the prevalence of skin tears (STs) within an acute care hospital. PARTICIPANTS AND SETTING: The setting was a 676-bed Midwestern urban teaching hospital with Magnet designation in the United States. All adult, children, and neonatal patients were assessed during the data collection period with the exclusion of the mother/baby unit and patients who were unsafe to move, actively dying, off the unit during the survey assessment, or those who declined participation. APPROACH: ST prevalence data were collected concurrently with the quarterly Pressure Injury Prevalence Survey over a period of 12-months (beginning the third quarter of 2017 through the second quarter of 2018) by the Pressure Injury Prevalence Survey Skin Care Champions using the revised Payne-Martin classification system for STs. A data collection form developed by the Wound, Ostomy, and Continence nurse was also completed for the patients with ST(s). OUTCOMES: The prevalence of STs was 2.92% (46/1576 patients). Twenty-one patients were women and 25 were men, with a mean age of 69.90 years (age range: 8 days-96 years). The majority of STs were found on the extremities (60 STs, 86.96%) and hospital-acquired (30 patients, 65.22%). Thirty STs (43.48%) were category III according to the revised Payne-Martin classification system for STs with major risk factors identified as frail skin (n = 34), advanced age (n = 30), and impaired mobility (n = 24). IMPLICATIONS FOR PRACTICE: STs are a common finding in the acute care setting spanning all age groups and are frequently overlooked by health care providers. This project provides a strategy to determine ST prevalence in a health care setting. Additional studies should focus on risk factor assessment and prevention strategies as these may decrease the incidence of this painful wound.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".