Foreword I n July 2019, a panel of wound care experts, educators and researchers met in the UK to review the literature on medical adhesive-related skin injury and discuss best practice for its assessment and prevention. e two-day meeting resulted in this consensus document, which is intended for anyone who uses adhesive medical devices. e document aims to raise awareness of the widespread occurrence of medical adhesive-related skin injury and the burden it imposes on patients, health professionals and the health service. It seeks to encourage a change in culture, whereby risk assessment and prevention of medical adhesive-related skin injury are considered an integral part of patient care. e document, therefore, provides recommendations for the assessment and prevention of this type of injury, with a view to standardising care across all healthcare settings. It also highlights the need for education on this form of skin damage, which needs to become a core topic in skin care and wound management. Until this happens, there is scope for multidisciplinary teams to provide local training on this subject. In the light of the panel's concern that many health professionals are not only unaware of this avoidable harm but also its abbreviation, MARSI, the term is written in full throughout the document. e panel hopes that implementation of the guidance in this document will reduce avoidable patient su ering and promote better outcomes. Sian Fumarola, Senior Clinical Nurse Specialist, Tissue Viability and Continence, University Hospitals of North Midlands NHS Trust, UK Overview of medical adhesive-related skin injury 'Medical adhesive-related skin injury' is a term used to defi ne any skin damage related to the use of medical adhesive products or devices such as tapes, wound dressings, stoma products, electrodes, medication patches and wound closure strips. This type of injury is largely avoidable
Moisture-associated skin damage, especially incontinence-associated dermatitis, continues to present significant health challenges and requires multidisciplinary input to provide effective prevention and treatment. In the absence of mandatory reporting such damage is under- or wrongfully reported, resulting in a lack of accurate data on prevalence and costs of associated care. In March this year, a multidisciplinary team of experts met in the UK to seek to determine measures to improve patient skin care. They aimed to identify activities to increase awareness and education, collect data, and improve prevention and treatment regimes. This article describes that discussion and the conclusions made by the group, such as the key actions required to effect policy changes.
Background: Between October 2017 and March 2018, the Trust experienced significant winter pressures and an increase in category 2 and 3 hospital-acquired avoidable pressure ulcers. This review aimed to investigate the causal factors of this increase. Methods: A ‘Deep Dive’ review of 37 cases was undertaken in three stages: (i) assurance; ensure the increase was not due to insufficient equipment; (ii) collation of relevant data, including age, length of time in A&E, bed surface, number of internal moves; (iii) analysis identifying factors that might account for the observed increase. Findings: Age combined with prolonged length of time in A&E, being nursed on a trolley followed by three or four internal moves were observed in patients who developed pressure ulcers. Patient age was observed as a key factor, with those over 80 years experiencing pressure ulcers more frequently. Conclusion: The small size of this data suggests a need for the greater awareness of frailty issues in older people, timely assessment and intervention to prevent a chain of detrimental factors might be key to reduce and prevent hospital-acquired avoidable pressure ulcers. Recommendations for immediate action, education and future research have been made to the Trust Quality and Safety Committee.
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