Nursing Home Nursing Staff Perspective About Using Subepidermal Moisture Technology for Pressure Injury Prevention

Journal of the American Medical Directors Association · 2026-04-24

BACKGROUND: Pressure injuries (PrIs) represent a persistent challenge in nursing homes, with facility-acquired rates of 8.5%. Subepidermal moisture (SEM) technology offers promise for early detection across all skin tones, yet remains underadopted in nursing home environments. PURPOSE: This qualitative study examined nursing home staff perceptions of SEM technology implementation using Rogers's Diffusion of Innovation theoretical framework to understand the overall adoption process. METHODS: Seven focus groups were conducted across 5 nursing homes with 50 staff members (registered nurses, licensed practical nurses, and certified nursing assistants) who had used SEM equipment during an 8-month intervention. Two facilities participated in temporal assessments at months 1 and 8. A directed qualitative content analysis was performed using 6 a priori codes derived from Diffusion of Innovation theory: observability, trialability, compatibility, relative advantage, and complexity. RESULTS: Analysis of 80 unique participant quotes yielded 132 coded instances across innovation characteristics. Notably, 68% of coded examples reflected negative perceptions of the technology, contrasting sharply with typical health care innovation adoption patterns. Key barriers included poor compatibility with existing workflows (35% of instances), implementation complexity extending beyond device operation (31%), mixed observability of benefits (32%), and concerns about relative advantage amid resource constraints (26%). Technology inflexibility prevented error correction and workflow adaptation (25%), whereas sustainability concerns emerged regarding long-term viability (17%). Temporal assessment revealed declining enthusiasm and compliance rates over the intervention period. CONCLUSIONS: Despite SEM technology's clinical potential, significant implementation barriers hindered adoption in resource-constrained nursing home environments. Findings highlight the critical importance of addressing workflow integration, organizational context, and staff burden when implementing health care innovations. Future implementation strategies must explicitly address resource constraints and develop comprehensive support systems that minimize workflow disruption while maintaining technology effectiveness.

Decreasing Intraoperative Skin Damage in Prone-Position Surgeries

Advances in Skin & Wound Care · 2024-07-22 · 3 citations

OBJECTIVE: To determine if subepidermal moisture (SEM) measures help detect and prevent intraoperative acquired pressure injuries (IAPIs) for prone-position surgery. METHODS: In this clinical trial of patients (n = 39 preintervention, n = 48 intervention, 100 historical control) undergoing prone-position surgery, researchers examined the use of multidimensionally flexible silicone foam (MFSF) dressings applied preoperatively to patients' face, chest, and iliac crests. Visual skin assessments and SEM measures were obtained preoperatively, postoperatively, and daily for up to 5 days or until discharge. Electronic health record review included demographic, medical, and surgery data. RESULTS: Of the 187 total participants, 76 (41%) were women. Participants' mean age was 61.0 ± 15.0 years, and 9.6% were Hispanic (n = 18), 9.6% were Asian (n = 18), 6.9% were Black or African American (n = 13), and 73.8% were White (n = 138). Participants had a mean Scott-Triggers IAPI risk score of 1.5 ± 1.1. Among those with no erythema preoperatively, fewer intervention participants exhibited postoperative erythema on their face and chest than did preintervention participants. Further, fewer intervention participants had SEM-defined IAPIs at all locations in comparison with preintervention participants. The MFSF dressings overcame IAPI risk factors of surgery length, skin tone, and body mass index with fewer IAPIs in intervention participants. CONCLUSIONS: Patients undergoing prone-position surgeries developed fewer IAPIs, and SEM measures indicated no damage when MFSF dressings were applied to sites preoperatively. The SEM measures detected more damage than visual assessment.

BUILDing Engaged Mentors: Examining the Efficacy of BUILD-led Mentor Training

The Chronicle of Mentoring & Coaching · 2024-06-01 · 1 citations

The practice of mentorship is a critical focus in science, technology, engineering, mathematics, and medicine (STEMM) disciplines. This quasi-experimental study investigated the efficacy of undergraduate mentor training in biomedical sciences programs in the NIH-funded Building Infrastructure Leading to Diversity (BUILD) initiative comprised of research-rising institutions. We used data from the Higher Education Research Institute's Faculty Survey (2016-17 and 2019-20). In cross-sectional comparisons of 379 BUILD-trained faculty with 755 colleagues who were not BUILD-trained, those who participated in BUILD mentor training reported more engagement with mentees. Utilizing propensity score matching of 314 with longitudinal cases, mentoring confidence and engagement were stronger over time for BUILD-trained faculty. Findings suggest BUILD mentor training yields positive results for undergraduate mentors at research-rising institutions.

Harmonization of four biomarkers across nine nationally representative studies of older persons

American Journal of Human Biology · 2023-12-09 · 2 citations

INTRODUCTION: A growing number of international population surveys have included measurement of biomarkers, but differ in the type of specimens collected, sample processing procedures, shipment protocols, and laboratory assay platforms. The purpose of this study is to harmonize biomarker data from nine nationally representative studies of people 50 years of age and over by adjusting for assay platforms and type of specimens for total cholesterol (total-C), high-density lipoprotein cholesterol (HDL-C), glycosylated hemoglobin (HbA1c), and C-reactive protein (CRP). METHODS: Sets of 24 identical serum, plasma, whole blood, and dried blood spot harmonization samples with known analyte levels were generated at a reference laboratory, shipped at -80°C to the respective study laboratories, and subsequently assayed following the study laboratory's protocol. Both original and harmonized study data were used to calculate mean values and at-risk prevalence. RESULTS: The correlation coefficients between the biomarker values of the harmonization samples obtained by the study laboratories and the reference laboratory were 0.99 or above for all analytes and laboratories, indicating the high quality of assays at all laboratories. However, using the harmonized data from each study, there were significant differences in the mean values and country ranking of the prevalence of at-risk levels of these four biomarkers. CONCLUSIONS: While the biomarker data from the different study laboratories were highly correlated, indicating very high correlation of rank order of specimens, absolute values did vary significantly. This can have a major impact on assessment of international differences in estimates of risks for chronic morbidity and mortality.

Everyday discrimination, emotion, and daily interactions during adolescence

Journal of Research on Adolescence · 2023-12-06 · 2 citations

The present study examined whether everyday discrimination relates to the frequency of adolescents' positive and negative daily social interactions and whether these associations are driven by anger and positive emotion. Adolescents (N = 334) participated in a three-wave longitudinal study, in which they completed surveys regarding everyday discrimination, anger, and positive emotion, as well as 15 daily reports of conflict and getting along with friends and family. Higher everyday discrimination was related to more daily conflicts and fewer experiences of getting along with other people. Longitudinal models also provided preliminary evidence that everyday discrimination was associated with daily conflicts 4 years later indirectly through anger. Overall, results suggest everyday discrimination relates to adolescents' daily experiences, potentially through differences in emotion.

Understanding the context and appreciating the complexity of evaluating the Diversity Program Consortium

New Directions for Evaluation · 2022-06-01 · 9 citations

The National Institutes of Health (NIH) made a sizeable investment in developing a scientific approach to understanding how to best increase diversity in the NIH-funded workforce by fostering inclusive excellence at a national scale through the Diversity Program Consortium (DPC). This chapter provides an overview of the context in which the consortium-wide evaluation study has taken place to provide readers with an understanding of its level of complexity. This evaluation effort is the first large-scale, national, systemic, longitudinal evaluation of harmonized interventions focused on undergraduate biomedical research training programs in the history of the NIH and the National Institute of General Medical Sciences.

Gauging treatment impact: The development of exposure variables in a large‐scale evaluation study

New Directions for Evaluation · 2022-06-01 · 4 citations

While guidance on how to design rigorous evaluation studies abounds, prescriptive guidance on how to include critical process and context measures through the construction of exposure variables is lacking. Capturing nuanced intervention dosage information within a large-scale evaluation is particularly complex. The Building Infrastructure Leading to Diversity (BUILD) initiative is part of the Diversity Program Consortium, which is funded by the National Institutes of Health. It is designed to increase participation in biomedical research careers among individuals from underrepresented groups. This chapter articulates methods employed in defining BUILD student and faculty interventions, tracking nuanced participation in multiple programs and activities, and computing the intensity of exposure. Defining standardized exposure variables (beyond simple treatment group membership) is crucial for equity-focused impact evaluation. Both the process and resulting nuanced dosage variables can inform the design and implementation of large-scale, diversity training program, outcome-focused, evaluation studies.

Low subjective social status is associated with daily selection of fewer healthy foods and more high-fat/high sugar foods

Appetite · 2022-10-07 · 18 citations

Socioeconomic status has been related to poorer eating behaviors, potentially due to feeling of lower status relative to peers. Despite experimental evidence that temporarily feeling of lower status can contribute to greater caloric intake, it remains unclear how feeling of lower social status relate to eating behavior in daily life. This study aimed to test whether lower subjective social status (SSS)-the feeling of having relatively lower social status-in American society and relative to college peers were related to daily food selection. A sample of 131 young adults (Mage = 20.3, SD = 0.8; 60% female; 46% Latinos; 34% European American; 15% Asian American; 5% of other ethnicities) reported their SSS in society and in college and completed 15 daily reports regarding the number of daily servings they had of fruits, vegetables, fried foods, fast foods, desserts, and sugary drinks. Multilevel models with days nested within individuals were used to test whether low SSS in society or college related to daily food intake. Next, we examined whether associations were driven by young adults' perceived stress and daily stressors. Analyses controlled for age, gender, ethnicity, family and personal income, and parents' education to test the unique associations between subjective status and food intake. Whereas SSS in society was not related to food intake, young adults with lower SSS in their college consumed fewer daily servings of healthy foods and more daily servings of high-fat/high-sugar foods. Although lower college SSS was related to greater perceived stress, perceived stress and daily stressors were consistently unrelated to daily food intake. Findings suggested that lower SSS in local environments (e.g., college) may impact young adults' daily food choices through processes beyond heightened stress.

Natural History of Pressure Injury Among Ethnically/Racially Diverse Nursing Home Residents: The Pressure Ulcer Detection Study

Journal of Gerontological Nursing · 2021-02-24 · 13 citations

The current observational study provides descriptive data on 270 pressure injuries (PrIs) among 142 racially/ethnically diverse nursing home (NH) residents over 16 weeks. Weekly assessments were conducted with the Bates-Jensen Wound Assessment Tool. NH data were obtained from public government websites. NH, resident, and PrI characteristics across race/ethnicity groups were compared using analysis of variance and chi-square. Participants were 62% female and 89% functionally dependent. More Black and Asian individuals had peripheral vascular disease. More Black individuals had persistent trunk and Stage 4 PrIs. Black and Hispanic individuals had normal skin color surrounding PrIs. More Asian individuals had PrIs surrounded by purple/red discolored skin. More Black individuals' heel PrIs were unstageable, necrotic, and showed no granulation. Black and Hispanic individuals exhibited more deep tissue injury. No NH or prevention differences existed. Health disparities found validate administrative data results. Differences in PrI characteristics should be further examined among diverse NH residents. [Journal of Gerontological Nursing, 47(3), 37-46.].

Sleep–Wake Timings in Adolescence: Chronotype Development and Associations with Adjustment

Journal of Youth and Adolescence · 2021 · 72 citations

• Psychology
• Developmental psychology
• Medicine