The Skin Safety Model: Reconceptualizing Skin Vulnerability in Older XXXX .

@entity1 @entity272
PURPOSE: To develop a unique skin safety model (SSM) that offers a new and unified perspective on the diverse yet interconnected antecedents that contribute to a spectrum of potential @entity272 in older hospitalized adults. ORGANIZING CONSTRUCT: Discussion paper. METHODS: A literature search of electronic databases was conducted for published articles written in English addressing skin integrity and iatrogenic @entity272 in elderly hospital @entity1 between 1960 and 2014. FINDINGS: There is a multiplicity of literature outlining the etiology, prevention, and management of specific @entity272 . Complex and interrelated factors contribute to iatrogenic @entity272 in the older adult, including multiple comorbidities, factors influencing healthcare delivery, and acute situational stressors. A range of injuries can result when these factors are complicated by skin irritants, pressure, shear, or friction; however, despite @entity272 sharing multiple antecedents, no unified overarching skin safety conceptual model has been published. CONCLUSIONS: The SSM presented in this article offers a new, unified framework that encompasses the spectrum of antecedents to skin vulnerability as well as the spectrum of @entity272 that may be sustained by older acute care @entity1 . Current skin integrity frameworks address prevention and management of specific @entity272 . In contrast, the SSM recognizes the complex interplay of @entity1 and system factors that may result in a range of @entity272 . Skin safety is reconceptualized into a single model that has the potential for application at the individual @entity1 level, as well as healthcare systems and governance levels. CLINICAL RELEVANCE: Skin safety is concerned with keeping skin safe from any iatrogenic @entity272 , and remains an ongoing challenge for healthcare providers. A conceptual framework that encompasses all of the factors that may contribute to a range of @entity272 is essential, and guides the clinician in maintaining skin integrity in the vulnerable older @entity1 .
