Shear is a risk factor for the development of pressure ulcers, especially deep tissue injuries. This occurs when the skin is under pressure and is dragged across a flat surface. A common example of when shear occurs is when a resident is dragged on his bed across the sheets.
When shear occurs, the small blood vessels which supply the skin with oxygen and nutrients are stretched and torn. This decreases the blood supply to the skin and increases the chance that there will be injury to the skin.
Identifying the presence of shear and/or risk of exposure to shear is one of the risk factors that a nurse is required to assess in doing a Braden Risk Assessment. If a resident is at risk for being exposed to shear, part of the care plan must include interventions intended to reduce or eliminate shear.