{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T13:42:42Z","timestamp":1790602962926,"version":"4.1.0"},"reference-count":43,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T00:00:00Z","timestamp":1705622400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim(s)<\/jats:title>\n                    <jats:p>To assess the effectiveness of sub\u2010epidermal moisture (SEM) assessment technology in the detection of early\u2010stage pressure damage in a critical care unit (CCU) and dark skin tone patients and its impact on hospital\u2010acquired pressure injury (HAPI) incidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Quality improvement study employing Kurt Lewin's change model emphasizing planning, implementation, evaluation and sustainable change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study evaluated 140 adult patients admitted to the CCU over a 24\u2010week period, from July to December 2022. Retrospective analysis of standard PI care pathways was performed in 90 patients admitted during a 12\u2010week pre\u2010implementation period. Fifty patients were admitted through the subsequent 12\u2010week implementation period. SEM assessments were performed daily at the sacrum and heels and interventions were applied based on SEM assessments; SEM delta \u22650.6 indicating localized oedema or persistent focal oedema. Statistical analyses were performed on anonymized data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Pre\u2010implementation HAPI incidence was 8.9% (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20098\/90). All eight patients were African American with varying skin tones. A 100% reduction in HAPI incidence was achieved in the implementation period which included 35 African American patients. The relative risk of HAPI incidence was 1.6 times higher in the pre\u2010implementation group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Implementing SEM assessment technology enabled equitable PI care for all population types and resulted in a 100% reduction of PIs in our CCU. Objective SEM assessments detected early\u2010stage PIs, regardless of skin tone and enabled providing interventions to specific anatomies developing tissue damage as opposed to universal preventive interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications<\/jats:title>\n                    <jats:p>PI care pathways relying on visual and tactile skin assessments are inherently biased in providing equitable care for dark skin tone patients. Implementing SEM assessments empowers healthcare practitioners in driving objective clinical interventions, eliminates bias and enables positive PI health outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>Implementing SEM assessment technology had three main effects: it detected early tissue damage regardless of skin tone (detection effect), enabled anatomy\u2010specific interventions (treatment effect) and prevented PIs across all population types (prevention effect).<\/jats:p>\n                    <jats:p>The authors have adhered to the Standards for Quality Improvement Reporting Excellence (SQUIRE) 2.0 guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>No patient or public contribution.<\/jats:p>\n                    <jats:p>\n                      <jats:italic>What does this paper contribute to the wider global clinical community?<\/jats:italic>\n                      Addressing health inequities in pressure injury prevention; Demonstrated effectiveness across patient populations; Resource optimization and enhanced patient safety.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jan.16040","type":"journal-article","created":{"date-parts":[[2024,1,20]],"date-time":"2024-01-20T01:39:42Z","timestamp":1705714782000},"page":"2801-2812","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Shedding new light for nurses: Enhancing pressure injury prevention across skin tones with sub\u2010epidermal moisture assessment technology"],"prefix":"10.1111","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6125-1714","authenticated-orcid":false,"given":"Cynthia","family":"Osborne\u00a0Chambers","sequence":"first","affiliation":[{"name":"Grand Canyon University  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7897-6201","authenticated-orcid":false,"given":"Julie A.","family":"Thompson","sequence":"additional","affiliation":[{"name":"School of Nursing, Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,19]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"AHRQ. 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