Reliability and Validity of the NE1 Wound Assessment Tool (WAT)

Abstract

Background and Purpose: Current literature indicates a lack of reliability and validity of existing pressure ulcer (PrU) staging systems. This prompted the development of the N.E. One Can Stage (NEOCS). Recently this tool was modified and renamed, the NE1 Wound Assessment Tool (NE1 WAT). The purpose of this study is to test the reliability and validity of the NE1 WAT. Subjects: A sample of convenience of nine physical therapists (PTs) and 11 nurses (RNs) with PrU staging as part of their routine work duties were included in this study. Methods: A written exam was administered and consisted of assessment questions that the subjects were to answer by using color photographs of 10 wounds. Subjects first completed the exam without exposure to the NE1 WAT, then a second time after an instructional presentation on the tool and its use. Seven to 10 days later, the test was completed for a third time, again with use of the NE1 WAT, without further instruction on use of the tool. Test-retest reliability was analyzed using the intra-class correlation coefficient (ICC), and evidence for validity was assessed using a paired t-test to compare the1st and 2nd test scores. Results: Reliability for all clinicians was ICC (2,1) = .670 (95% CI: .333 to .855). Comparisons for all clinicians between tests 1 (mean=73.05, SD= 9.66) and 2 (mean= 80.85, SD= 11.65) revealed a significant difference between the means,t(19) = -3.640, p=.002. Discussion: The NE1 WAT demonstrated moderate reliability and significantly improved the accuracy of PrU staging and wound assessment for subjects. Conclusion: The NE1 WAT is a reliable and valid tool to improve healthcare clinicians’ ability in staging PrUs.