Improving Skin Assessment Skills of Registered Nurses for All Skin Tones BACKGROUND • Early detection of pressure injuries is more challenging in individuals with darker skin tones. • Pressure injury prevalence is nearly twice as likely in Black patients compared to white patients; stage 2-4 is almost three times more likely. 1 • Clinical and academic education is lacking; the lack of regional diversity affects confidence in assessing various skin tones. 2 • The project aims to bridge the gap by providing comprehensive education and standardized skin assessment practices regardless of skin tone.3 • Methods include understanding the types of Braden Scales, interpreting the scores, and incorporating touch, appropriate lighting, and effective communication with the patient during the assessment. 4,5 METHODS Brandon “Patch” Crosby, BSN, RN, MSN Student JoAnn Tolman, DNP-L, MSN-Ed, RN, CNE McCall Shugars, MSN, RN INTERVENTIONS Step 1: A pre-survey was created to assess the confidence levels of nurses in conducting skin assessments on darker skin tones, their current practices, and reporting abnormal findings. Step 2: One-hour presentation to registered nurses on evidence-based techniques for skin assessments and tools. Step 3: An Infographic was created to be distributed and displayed in patient areas. Step 4: Two months have been allotted to utilize the infographic and incorporate education into nursing practice. Step 5: A post-survey was created to gather feedback on participants’ confidence in skin assessments. IMPACTS • Increase confidence in registered nurses’ skin assessments and reporting. • Foundational education that can be built upon. • Decrease in pressure injuries for all patients. Framework: Iowa Model for Evidence-Based Practice and Excellence • Equitable health; reduction in disparities • Pre-and post-surveys were created to assess the confidence levels of registered nurses in skin assessments and reporting abnormal findings • A PowerPoint presentation was created to serve as a resource for a one-hour presentation. CONCLUSIONS • An infographic was created to serve as a resource in patient areas. REFERENCES 1Black, J., Cox, J., Capasso, V., Bliss, D. Z., Delmore, B., Iyer, V., Massaro, J., Munro, C., Pittman, J., & Ayello, E. A. (2023). Current perspectives on pressure injuries in persons with dark skin tones from the national pressure injury advisory panel. Advances in Skin & Wound Care, 36(9). https://doi.org/10.1097/asw.0000000000000032 2 Oozageer Gunowa, N., Hutchinson, M., Brooke, J., Aveyard, H., & Jackson, D. (2021). Pressure injuries and skin tone diversity in undergraduate nurse education: qualitative perspectives from a mixed methods study. Journal of Advanced Nursing, 77(11). https://doi.org/10.1111/jan.14965 3 Dowley, V. (2023). Assessing pressure ulcers in patients with darker skin tones. Oska. https://oska.uk.com/assessing-pressure-ulcersin-patients-with-darker-skin-tones/ 4Hanlon, K. L., Wei, G., Correa-Selm, L., & Grichnik, J. M. (2022). Dermoscopy and skin imaging light sources: a comparison and review of spectral power distribution and color consistency. Journal of Biomedical Optics, 27(08). https://doi.org/10.1117/1.jbo.27.8.080902 5Fletcher, J., & Oozageer Gunowa, N. (2021). Skin assessment: Assessing skin on patients with darker skin tones in relation to PU prevention. Society of Tissue Viability. Retrieved August 18, 2024. https://societyoftissueviability.org/resources/skin-assessmentassessing-skin-on-patients-with-darker-skin-tones-in-relation-to-pu-prevention Addressing disparities in skin assessment requires targeted education and systematic changes in nursing practice. The project demonstrated that standardizing skin assessment techniques, regardless of patient population, improves registered nurses’ confidence in assessing all patients, particularly those with darker skin tones. Hospitals and higher education institutions should implement similar practices to promote equitable patient care and reduce disparities in the detection of pressure injuries.