Abstract
To compare the reliability and predictive validity of the Braden and Jackson/Cubbin PI risk assessment scales in intensive care unit patients. Risk assessment with a standardised tool is the usual intervention for preventing pressure injury. Therefore, tools used to assess pressure injury risk should be valid and reliable for the designated patient population. A prospective and cross-sectional study adheres to the STARD guideline. This study was conducted between November 2017-April 2018 in the intensive care units of a tertiary level university hospital in Turkey. The study sample consisted of 176 patients admitted to three intensive care units. Risk assessment was performed once daily with the Braden scale, followed immediately with the Jackson/Cubbin scale. Risk assessment was terminated on the day of pressure injury development or upon patient discharge from the intensive care unit. Each patient's final risk assessment was considered in the data analysis. The Cronbach's alpha coefficient of the Jackson/Cubbin and Braden scales was .78 and .85, respectively. The predictive validity of the Jackson/Cubbin scale was confirmed by a sensitivity of .87, specificity of .84, positive predictive value of .47 and negative predictive value of .97. These values for the Braden scale were .95, .75, .38 and .99, respectively. Both the Jackson/Cubbin and Braden scales are reliable and valid scales for pressure injury risk assessment in intensive care unit patients. However, the predictive ability to determine patients at risk and not at risk for pressure injury was better for the Jackson/Cubbin scale than for the Braden scale. Both scales are reliable and valid scales for pressure injury risk assessment. Jackson/Cubbin scale's discriminative ability (between the patients at pressure injury risk and not at pressure injury risk) was better.
Highlights
Pressure injuries (PIs) are a largely preventable healthcare problem in all areas of health care
García‐Fernández, Pancorbo‐ Hidalgo, and Agreda (2013), who conducted a systematic review and meta‐analysis on PI risk assessment scales in Intensive care units (ICUs) patients, reported that the Braden scale has the highest validity among the available scales (García‐Fernández et al, 2013)
These discrepancies raise questions re‐ garding the validity and reliability of the Braden scale as a risk assessment tool for ICU patients. The recognition of these limitations led to the development of the Jackson/Cubbin scale to assess PI risk in ICU patients. This scale consists of both general risk factors and ICU patient‐specific risk factors and includes age, weight, past medical history, general skin condition, mobility, nutrition, incontinence, hygiene, mental condition, haemodynamics, respiration and ox‐ ygen requirement (Jackson, 1999)
Summary
Pressure injuries (PIs) are a largely preventable healthcare problem in all areas of health care. In the ICU, the most commonly used PI risk assessment tool is the Braden scale (Balzer, Pohl, Dassen, & Halfens, 2007; Kılıç Fırat & Sucudağ, 2017; Magnan & Maklebust, 2009; Seongsook, Ihnsook, & Younghee, 2004). This scale was developed for use in the gen‐ eral population and consists of the following categories: sensory perception, moisture, activity, mobility, nutrition, friction and shear (Bergstrom, Braden, Laguzza, & Holman, 1987). Some other studies reported limitations of the Braden scale items
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