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Prevention/Skin Equity


A Clinical Concept led by Smith & Nephew

Invest in Prevention
SKIN EQUITY is a prevention philosophy from Smith & Nephew that embodies our Living Vision to improve quality of life. This approach to protecting skin and preventing skin breakdown combines medical education programs with a complete skin care product line to help create clinical, emotional, and financial benefits in healthcare settings.

The Clinical Need
Pressure ulcers pose a significant public health problem, with the incidence ranging from <1% to 38% in the acute setting and from 2.2% to 23.9% in the long-term setting.>1 Skin tissue injuries deplete healthcare resources at an alarming rate, with the expense of treating one case ranging from $500 to $50,000. 2,5 In an acute-care setting, the average length of hospital stay can increase by 4 to 17 days among patients with pressure ulcers and related complications. 3

The Emotional Need
The development of a preventable pressure ulcer can be devastating to patients, families, and staff. Published literature suggests that good preventive care can result in less skin breakdown and fewer pressure ulcers leading to emotional benefits for patients, families and caregivers. Good skin care can have a positive impact on the patients' overall health, including morale and self-esteem and may result in less potential for pain and infection. Families may be reassured when quality care is evident and gain confidence in the staff and facility. Caregivers are motivated when they see the difference they can make. And a motivated staff leads to increased employee satisfaction and lower staff turnover rates.

The Financial Return
Proactive prevention programs may deliver a financial benefit by reducing overall treatment costs. Incremental costs associated with skin breakdown and tissue damage, like increased patient morbidity and longer hospital stays, may be minimized or even avoided. Consistent preventive care may decrease the likelihood that a patient will develop a pressure ulcer which may put the patient at risk for other complications that could result in fines or lawsuits. Clinical evidence now shows that establishing preventive skin care protocols may significantly reduce the incidence of pressure ulcers. 4 The federal government, through the Agency for Healthcare Research and Quality (AHRQ), developed and instituted guidelines for the prevention of pressure ulcers. The goal of the SKIN EQUITY prevention philosophy is to educate caregivers about the benefits of prevention so that the incidence of pressure ulcers and other skin breakdown may be reduced, leading to improved patient care, motivated caregivers, and a potential reduction in total healthcare costs.

Building A Strong Foundation
One goal of the SKIN EQUITY prevention program is to inspire caregivers by providing consistent education, training, and high-quality products. Adopting the AHRQ guidelines and staying current with the latest clinical research helps to ensure high-quality care.

Topics addressed by the SKIN EQUITY educational program include:

  • skin anatomy and physiology
  • factors associated with aging and other at-risk skin
  • risk assessment tools and the use of risk scores
  • principles of wound prevention and early intervention
  • designing and implementing best-practice skin care protocols
  • considerations in mechanical loading and support surfaces
  • clinically based in-services for prevention education and product training
  • continuing education unit-accredited education for nurses
  • prevention education specifically designed for nursing assistants
  • overview of skin care ingredients, their functions, and benefits

The SKIN EQUITY philosophy is an investment in caregivers and patients that may result in positive clinical, emotional, and financial outcomes.

  1. Knowledge. With knowledge, caregivers may prevent or reduce skin breakdown. Preventive skin care is important to the patients' quality of life. Understanding the anatomy and physiology of skin and what risk factors contribute to breakdown is intended to empower employees to intervene earlier and take ownership for patient care
  2. Prevention. All skin care products are not created equal. They are intended for different clinical situations. Protecting vulnerable skin means knowing what products to use and how and when to use them. It is important to know what ingredients to look for in skin care products -- and which to avoid
  3. Results. Preventive skin care may pay off clinically through improved outcomes and fewer complications, including a decreased incidence of pressure ulcers. Financial benefits may be seen in shorter hospital stays, lower treatment costs, and less potential for exposure to liability. Emotionally, when staff members see their efforts make a difference in patient care, it can build teamwork, motivation, and ownership.


A Clinical Concept led by Smith & Nephew

  1. Pressure ulcers in America: prevalence, incidence, and implications for the future: an executive summary of the National Pressure Ulcer Advisory Panel monograph. Adv Skin Wound Care. 2001; 14:208-215.Lyder CH, Yu C, Emerling J, et al.
  2. The Braden Scale for pressure ulcer risk: evaluating the predictive validity in Black and Latino/Hispanic elders. Appl Nurs Res. 1999;12:60-68.
  3. Allman RM, Goode PS, Burst N, Bartolucci AA, Thomas DR. Pressure ulcers, hospital complications, and disease severity: impact on hospital costs and length of stay. Adv Wound Care. 1999;12:22-30.
  4. Regan MB, Byers PH, Mayrovitz HN. Efficacy of a comprehensive pressure ulcer prevention program in an extended care facility. Adv Wound Care. 1995;8(3):49-55.
  5. Lyder CH, Shannon R, et al. A Comprehensive Program to Prevent Pressure Ulcers in Long-Term Care: Exploring Costs and Outcomes. Ostomy Wound Mgmt, 2002;48(4):52-62.