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How Certified Nursing Assistants Can Prevent Skin Tears

Skin tears represent a major problem affecting the elderly residents in nursing facilities. It has been estimated that at least 1.5 million skin tears occur in institutionalized residents every year. They can cause the resident to suffer a great deal of pain, the Certified Nursing Assistant to waste precious time and the nursing facility to lose money.

What is a skin tear
A skin tear is a traumatic wound that occurs primarily on a persons extremities, with 80% of skin tears occur on arms and hands.  It is the result of friction alone or shearing and friction forces which separate the epidermis from the dermis (partial thickness wound), or separates both the epidermis and the dermis from the underlying structures (full thickness wound). 

As we age our skin becomes more thin and fragile.  Even the slightest pressure can cause a skin tear.  Wound complications can develop because of skin tears.  If they do occur, it needs to reported immediately to the charge nurse. 

What Residents are at risk for skin tears
  • Those with a history of previous skin tears
  • Residents with compromised nutrition
  • Those who are dehydrated
  • Residents with confusion
  • Limitations in mobility
  • Being very thin
  • The use of certain medications, such as steroids, also makes skin more prone to injury causing skin tears

Although skin tears can be difficult to prevent and treat, CNAs can limit their impact by following these few key tips.

Skin Tear Care Plan

  • Dressing residents in long sleeves and long pants
  • Using gentle adhesives
  • Treating the residents very gently for activities of daily living (ADLs)
  • Keeping the resident well hydrated by increasing fluid intake
  • Applying frequent topical moisturization
  • Avoid wearing rings
  • Keeping nail cut short
  • Use draw sheets to assist in moving and transferring residents
  • Make sure that padding in on equipment such as the arms of wheelchairs

Skins tears happen, however, with these tips and with proper patient handling together as a healthcare team your nursing facility has the potential to be virtually free of skin tears!