Developing an Australian skin risk assessment and management tool for neonates




Broom, Margaret
Burton, WA
Ehrlich, LM
Dunk, AM
Mohamed, Abdel-Latif

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Cambridge Publishing


Background: Skin injuries are a common occurrence in neonatal units. Currently there are few tools that meet the specific needs of the neonatal population. To assist nurses in identifying neonates at risk and improve neonatal skin care, a working group developed a neonatal skin risk assessment and management tool (SRAMT) for their unit. <br /><br /> Setting: University-affiliated tertiary neonatal intensive care unit (NICU). <br /><br /> Design: Single-site prospective longitudinal study (2010-2014). <br /><br /> Method: The study was conducted over three phases: 1) skin injuries incidence study; 2) development of the SRAMT; and 3) post-implementation review of the SRAMT. <br /><br /> Results: The SRAMT lists eight risk categories: gestational age, sensory perception, activity/mobility, moisture, respiratory support, visual examination, blood collection and nutrition and these categories are graded from low (grade 1) to extreme risk (grade 4). The tool also provides assessment and management guidelines. Evaluation of the SRAMT showed a reduction in neonates who acquired skin injuries pre SRAMT from 37/60(61.7%), compared to post 12/30(40%), (OR 0.41 95% CI 0.17-1.02; p-value 0.085). <br /><br /> Conclusion: The study has shown introducing a skin risk assessment tool may reduce the incidence of skin injuries and standardise skin management in the NICU. Future research will be undertaken to validate the SRAMT and assess its suitability across neonatal units.



Neonates, skin injuries, risk assessment, pressure injuries, neonatal intensive care unit



Wound Practice & Research


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