As we age, our skin can experience changes that make it more vulnerable to damage.

Older people, especially those who are frail, are at significant risk of developing pressure injuries and skin tears.

Hospital acquired pressure injuries and skin tears are considered an adverse event. Most pressure injuries and skin tears can be prevented by following simple steps such as maintaining good nutrition and hydration, regular but careful mobilisation, good skin hygiene and a good moisturising regime.

This topic defines pressure injuries and skin tears and their impacts; describes methods of screening and assessment for risk; and recommends interventions to prevent and manage pressure injuries and skin tears. In addition to following health service policy and procedures, consider the following actions and discuss them with colleagues and managers.

All Australian hospitals are being accredited under The Australian Commission on Safety and Quality in Healthcare’s (ACSQHC) National Safety and Quality Health Service (NSQHS) Standards. Each of the ten standards relate to optimising clinical care and better outcomes for all patients. While identifying and responding to issues of preventing and managing pressure injuries (standard 8) is directly referred to within the NSQHSS, this topic highlights the need to approach the clinical issues older people face in hospital in a holistic and person centred way in order to identify and respond to multiple modifiable risk factors throughout their stay. In addition to assisting us to meet standard 8, this topic relates to preventing falls and harm from falls (standard 10), medication safety (standard 4) and to improving our identification and response to people presenting with or developing a cognitive impairment (cognition clinical care standard).

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