SKINCARE - Enhancing SKIN health and safety in aged CARE: an exploratory cluster-randomized pragmatic trial

Background
Implementing evidence-based skin care in older people in need for care can help to promote skin integrityin this vulnerable population.

Objective
The overarching aim of the SKINCARE study was to evaluate the impact of an evidence-based skincare programme on skin integrity and resident-relevant outcomes, such as quality of life, among older adults living in long-term care facilities. A secondary objective was to assess potential changes in nursing decision-making and care practices related to personal and skincare support (process evaluation).

Methods
The study was conducted as a cluster-randomized controlled trial with a complex intervention and an accompanying process evaluation across 20 nursing homes in Berlin. In half of the participating facilities, the evidence-based skincare guideline was implemented (intervention group), while the other half served as a control group. At the end of the study, differences in skin health between the two groups were assessed. The process evaluation examined the implementation of the skincare programme, the feasibility of the intervention, the influence of relevant contextual factors, and potential interactions with intermediate outcomes. A mixed-methods approach was employed, incorporating qualitative and quantitative methods such as non-participatory observations, individual interviews, focus groups, and standardized surveys.
Prior to the process evaluation, a pilot study (SKINCARE-Pilot) was carried out in three nursing homes in Lübeck to develop and test the evaluation instruments and procedures.