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Nursing & Health Sciences Research Journal

Abstract

Introduction: Acute skin failure (ASF) in hospitalized patients is a growing concern and a product of multisystem organ failure. Unlike hospital-acquired pressure injuries (HAPIs), ASF is not preventable despite prevention measures. The Skin Failure Clinical Indicator Scale (SFCIS) was recently developed to assess the probability of ASF. The purpose of this study was to retrospectively examine the probability of and factors associated with ASF in hospitalized individuals with HAPIs.

Methods: Data were collected from the electronic health records of in-patients with stage 3 or greater HAPIs over two years. Collection included demographics, comorbidities, COVID status, wound staging, injury location, SFCIS, and additional clinical indicators. The data analysis plan included descriptive statistics, correlation analyses, and multiple linear regression analysis.

Results: Among 104 participants, the SFCIS scores showed 44% with moderate ASF probability, 34% low probability, and 22% high probability. Correlation analyses showed the following statistically significant positive and negative relationships with SFCIS scores: negative—age; positive—total length of stay (LOS), intensive care unit LOS, admitting diagnosis, comorbid cardiovascular disease, and COVID-19 positive status.

Discussion: Distinguishing between ASF and HAPI is paramount to diagnosis accuracy. Alarmingly, when considering high and moderate probability together, 66% of the sample possibly had ASF, provided that all prevention measures were in place. Our results provide valuable insight to support incorporation of ASF probability assessment into nursing practice to promote early identification, thus potentially preventing HAPI misidentification and the associated negative sequelae. However, more research on the SFCIS’s reliability and validity are needed.

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