Skin Care Team in the Pediatric Intensive Care Unit: A Model for Excellence

A team committed to a specific entity such as skin care can enhance resource availability, communication, and follow-through.

The skin is the largest organ of the body and has many complex functions.¹ Intact skin is a barrier to infection; thus, alteration in skin integrity predisposes patients to infection and poor outcomes. Pressure ulcers are an important iatrogenic problem in health care with substantial financial costs.^2,3 In a study of adverse events, Cho et al⁴ reported that pressure ulcers had the greatest effect on length of stay, with a 1.84-fold increase in stay for patients with such ulcers. Among the 7 groups of adverse events examined, pressure ulcers were the third most significant determinant of increased costs, after sepsis and pneumonia.⁴ Impaired perfusion, altered nutrition, unstable hemodynamic status, limited mobility, immunosuppression, and medications contribute to risk associated with altered skin integrity for critically ill children....