Point of Care Subepidermal Moisture (SEM) Scanning Technology to Detect Pressure Injury: A Pilot Study

The subepidermal moisture (SEM) scanner measures changes in electrical properties of the tissue several millimetres below the skin as a result of inflammation secondary to damage caused by pressure/shear. This device reports the level of electrical change at a tissue site as a SEM value. Comparison of the inflamed area with nearby adjacent healthy tissue identifies the maximum difference between the SEM values and is known as the SEM-delta, the parameter of clinical interest. The higher the SEM-delta, the higher the oedema and expected tissue damage at the site, with a SEM-delta reading of 0.6 indicative of a higher risk of pressure injury (PI). The intervention is SEM scanning of the sacrum and heels undertaken Monday to -Friday. The RA will record and report the SEM reading to the Nurse as either indicating or not indicating early tissue damage that may develop into a pressure injury. Participants in both groups will receive standard PI prevention care and be visited by the Research Assistant Monday to Friday who will conduct a visual skin assessment to detect PI, and data collection on PI prevention strategies implemented. Participants will be followed up for 14 days or until the trial end points; development of sacral or heel hospital-acquired PI, transfer to intensive care, hospital discharge or death, whichever occurs first. If a hospital-acquired PI is identified by the RA during visual skin assessment and data collection, the bedside nurse will be informed, and the participant will exit the study. Participants in the intervention group will receive routine PI prevention care which we will not have any influence over. Participants in the intervention group will have their sacrum and heels SEM Scanned once daily, Monday-Friday by the research assistant. The SEM Scanning process is non-invasive, painless and will take approximately 10 minutes to complete. It will feel like a small firm object is being held in several different location on the heels and the sacrum. We will endeavor to co-ordinate the SEM scanning process with the participant's routine pressure injury prevention care to minimise any disruption for the patient. The research assistant will report the SEM value to the bedside nurse as either normal 0.6 or less, or abnormal with a score of greater than or equal to 0.6, indicative of early tissue damage. The SEM results will also be recorded in the participants medical record. Feasibility Data The RA will keep logs (i.e., screening logs and intervention fidelity logs) to measure feasibility outcomes. Acceptability Outcomes The analysis and subsequent findings will provide insights into patients’, family members’ and healthcare professionals perceptions and experiences of intervention acceptability. The analysis and subsequent findings will provide insights into patients’, family members’ and healthcare professionals perceptions and experiences of intervention acceptability.