Use of Munsell color charts to measure skin tone objectively in nursing home residents at risk for pressure ulcer development.
Heather E McCreath, Barbara M Bates-Jensen, Gojiro Nakagami and 5 others
PMID 27062396WHAT IT FOUND
Munsell color charts reliably measured nursing home residents' skin tone and predicted early sacral pressure damage better than race or ethnicity.
Heel findings were weaker, so direct skin checks remain essential.
Key findings
01Munsell skin tone values were stable from baseline to 8 weeks and to 16 weeks, with intraclass correlations of 0.86 and 0.85 for the arm and 0.90 and 0.91 for the buttock.
02Erythema and stage 1 pressure damage were less often observed in residents with dark and medium skin tones, regardless of ethnicity/race.
03At the sacral site, Munsell skin tone categories were stronger predictors of erythema and stage 1 pressure damage than ethnicity/race.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Munsell values were not collected for the heel, so skin tone on the trunk or arm may not match heel skin tone. The study did not include large numbers of Pacific Islanders, Native Americans, people with ancestry from the Indian subcontinent, or people identifying with more than one ethnicity/race group. This was an observational study, not a test of whether using a Munsell chart prevents pressure ulcers or improves patient outcomes. The analysis used 417 of the 490 enrolled residents after exclusions.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that using a Munsell chart prevents pressure ulcers or can replace direct skin checks. The study observed skin tone and pressure damage, did not test the chart as a prevention intervention, and did not measure heel skin tone.