Doctor of Nursing Practice
Dorothea Esposito, PhD(c), DNP MSN/ed, APRN, FNP-BC
Maurice Hinson, MD
Significance and Background: The skin is the largest organ of our body, and skin injury prevention begins with accurately inspecting skin. Current practices stress on looking for any signs of redness which often signify that the skin is possibly injured or compromised. However, darker skin tones do not appear red when injured. Assessing for redness is a practice that is suited better for lighter skin tones.
Purpose: Provide education to providers on current skin assessment practices of darker skin tones.
Methods: The IHI Model of Improvement was used for this project, and the Plan-Do-Study-Act cycle was used to test for changes.
Outcome: There was an overall increase of 4.65% in documentation in the skin sections of the EMRs, and a 47/90 (41.11%) increase in all audited charts with words of ashen/ashy gray, dark brown, and purple. In all documented charts, there was a 37/47 (78.72%) increase of the above descriptors. All providers and RNs agreed feeling an increase in knowledge on this subject.
Discussion: Overall, there was an increase in documentation in the skin sections of patient’s charts, and with words of either ashen/ashy gray, darker brown, and purple. In the future this project may be helpful to apply in inpatient settings. The next steps would be to continue expanding on this knowledge and continue teaching providers, and to incorporate a narrative system into the EMR systems.
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Akiba, T. (2023). Application of teaching regarding injury appearance in darker pigmented skin patients: A quality improvement project [Unpublished DNP project]. Sacred Heart University.