GH GHNHSFTeLearning Portal

Skin inspection for tissue viability training

The Gloucestershire Hospitals NHS Foundation Trust eLearning portal provides this module’s activities on skin checks, tissue viability and pressure-injury prevention. For Australian staff, the clinical principles are transferable, but assessment criteria, referral routes, documentation and product choices must follow local policy.

Completion generally involves reviewing the content, working through scenarios, completing knowledge checks and confirming any supervisor-required practical learning. Keep notes beside the course. If the module will not open, progress will not save or material is missing, contact the Gloucestershire Hospitals eLearning Helpdesk by phone or email with your device, browser and the point where the problem occurred.

Understand the purpose of the module

Skin inspection is a systematic review of the skin and underlying tissue, not simply a glance for redness. The module develops observation skills for pressure areas, early pressure injury, pressure ulcers, skin breakdown, moisture-associated skin damage and changes caused by friction, shear or poor nutrition. It supports prevention as well as detection.

It helps distinguish risk from deterioration and shows when a senior assessment is needed. Suspected deep tissue injury, spreading redness around a wound, unexplained pain, a new blister, or unusually warm, firm, swollen or cool tissue should be reported through the local escalation process. A tissue viability nurse or wound-care specialist can review the patient and guide treatment.

Australian hospitals also work within the Australian Commission on Safety and Quality in Health Care’s National Safety and Quality Health Service Standards, particularly its expectation of comprehensive, coordinated care. These accreditation standards support the module, while state and territory Work Health and Safety legislation sets legal duties for safe systems, equipment, training and hazard reporting. Local policy determines the checklist and who must be notified.

Prepare for the learning activity

Before starting, confirm that your account is active, update the page and test audio, video and interactive items. Read the instructions for attempts and feedback, then gather notes because prompts may ask you to rank observations, choose actions and explain your reasoning.

Consider common presentations in Australian hospitals. Brisbane and Darwin often bring heat and humidity that increase sweating, while indoor air-conditioning can dry skin. Perth’s hot, dry climate and frequent cooling can reduce skin resilience, and Sydney’s coastal humidity can compound moisture risk. Daily habits vary: patients may wear sandals or shorts, work outdoors, exercise regularly or use a walking frame, affecting inspection and pressure-injury risk.

Do not bring personal wound products into a clinical area unless the service approves them. Australian patients may encounter dressings through hospital formularies, community pharmacies or online suppliers, but availability varies by location. Following the local formulary supports continuity and ensures products are used with the correct sizing, instructions and clinical assessment.

Carry out a consistent inspection routine

Begin with hand hygiene, privacy and an explanation of the examination. Ask about pain, numbness, falls, pressure relief, mobility changes and areas of concern. Use good light, expose the skin systematically and compare similar areas. If the patient declines an area, record the limitation as required and continue with the rest of the examination.

Work from head to toe, focusing on the sacrum, coccyx, heels, shoulders, elbows, hips and knees. Check skin folds, dressings, tubing and pressure-relieving equipment for damage or excessive moisture. Look and palpate for changes in colour, temperature, texture, firmness, swelling, tenderness and moisture. On darker skin, redness may be hard to see, so changes in temperature, shine, tightness or tissue consistency can be more significant than colour alone.

Inspection focus

Immediate actions

A consistent routine keeps deterioration from being lost between shifts. It also gives the receiving team a clear record of what changed and what action was taken.

Recognise changes and escalate concerns

Pressure injury can begin below the surface, so a normal-looking area may conceal deeper tissue injury. Do not massage a suspected pressure area, rely on redness as the only warning sign, or dismiss pain because skin colour has not changed. If the patient becomes systemically unwell, follow the service’s rapid-response process rather than waiting for the wound team.

Lower-limb protection needs particular attention in people with diabetes, neuropathy, peripheral vascular disease, oedema or reduced mobility. Inspect between the toes, around heels and over bony areas, and ensure footwear, compression garments and mobility aids do not cause damage. For lower-limb protection, the professional learning resources can support revision alongside this module.

Australia’s high UV exposure adds another consideration, but a tissue viability check is not a skin-cancer screening appointment. Refer a changing mole, non-healing lesion or unexplained bleeding through the appropriate service. A painful, warm, swollen or purulent wound also needs infection assessment, with urgent escalation if the patient shows signs of sepsis.

Document the assessment and complete the module

Record facts another clinician can compare with later observations: date and time, exact site, dimensions, colour change, pain, temperature, moisture, equipment contact and wound appearance. Use approved terms and describe what is visible rather than attaching an uncertain diagnosis. Record pressure relief, advice given, person notified, clinical response and product changes. Photography must follow local consent, storage and privacy rules.

Work through the module in the sequence shown, save completed sections and review feedback. Practical questions may test whether you would continue observing, escalate immediately or involve a specialist, so explain your reasoning. If your organisation requires observation or competency sign-off, arrange it with the designated assessor and use the same checklist used at the bedside.

Keep completion evidence according to your employer’s learning-record process. For technical problems, contact the Gloucestershire Hospitals eLearning Helpdesk by phone or email with the module name, account details, device and browser. For uncertain clinical answers, use the tissue viability service or clinical lead rather than treating the Helpdesk as a source of patient-specific advice.

Turn learning into safer routine practice

Good assessment continues beyond the online session. At admission, after a change in mobility or equipment, and during handover, ensure at-risk patients receive a complete skin check and new findings are shared with the team. Involve the patient, use an interpreter when needed, and follow local cultural safety protocols for Aboriginal and Torres Strait Islander patients. During transfers between hospital, community and aged care, communicate risks and equipment needs clearly.

Clinical records must comply with the Privacy Act 1988 and applicable state or territory health-records legislation, while employers use Work Health and Safety laws and incident reporting to investigate preventable harm. Report pressure injuries according to local policy, including whether an event occurred in the service or on arrival. The practical takeaway is to make one complete, documented skin assessment part of every shift handover for every patient at risk, with concerns acted on before the next handover.