Date of Award

Summer 2020

Document Type

Final DNP Paper

Degree Name

Doctor of Nursing Practice (DNP)



Faculty Chair

Dr. Lori S. McGrath


Skin tears create numerous challenges for managing skin integrity for our aging population. Skin tears result from trauma, such as a patient bumping into a doorknob or rubbing against the wheelchair; they also occur because the epidermis and dermis lose elasticity and rub against each other, causing a shearing process that separates the outer skin layers from their protective under layers. Skin tears not only look terrible but can be painful and lead to infection if treatment is not initiated early by the nurse.

Purpose: The Chief Nursing Officer chose to focus on skin tear treatment at a southeast urban hospital since data existed that the current protocol was confusing, and the staff needed education on the new protocol and the importance of addressing skincare quickly. Informal discussions with the primary nurses found that nurses were not using a standard approach and often waited on the wound care team to handle skin tears. This delayed treatment and increased the patient's potential for infection. A standardized Skin Tear Protocol was needed to ensure the rapid assessment and treatment of skin tears.

Design Methods: This DNP project implements an evidence-based practice project with a quality improvement intervention that involves developing a standardized Skin Tear Protocol to assist the primary nurse in identifying skin tears and improving treatment initiation time for skin tears. A pretest and posttest were administered during the education course to each participant to assess their understanding of skin tears. Thirty-six randomly selected participants agreed to participate in the project.

Implications for Nursing: A statistician performed the data analysis and used the paired t-test and the two independent sample tests, which showed there was not a significant difference between the two groups. By utilizing the standardized Skin Tear Protocol, the DNP student and the primary nurses can contain cost and decrease patient pain levels by implementing treatment while reducing the infection rate. By understanding and using the standardized Skin Tear Protocol, the primary nurse is ready to teach everybody about skin tears and skin tear care treatment. Education is the key to preventing skin tears.

Included in

Nursing Commons



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