Abstract
BackgroundPressure injures are a common adverse event in a hospital, and they are one of the most important quality indicators of patient care. Risk assessment is recommended as the first step in the prevention of pressure injuries. A Prevent Pressure Injury Risk Assessment Tool is a new tool for risk assessment that was developed by the Helsinki University Hospital.AimThe aim of this study was to evaluate the predictive validity and the concurrent validity of the Prevent Pressure Injury Risk Assessment Tool in acute care.MethodThe prospective observational study was conducted in 19 in-patient wards representing internal medicine, neurology, and surgery during 2017–2018. The participants’ inclusion criteria were: age ≥18 years old, no pressure injury on admission to the hospital and consenting to participate. The data collected by physical assessment of patients was combined with data from electronic patient records. Each patient was assessed by two different nurses with the Prevent Pressure Injury Risk Assessment Tool and the Braden Scale at patient admission. Furthermore, skin condition was observed throughout the hospital stay.ResultsOf the 637 patients accepted for the study, 10 (1.6%) developed a pressure injury during the hospital stay. Poisson regression analysis showed that pressure injuries were more likely in high–risk patients compared to those with low-risk. The sensitivity of the Prevent Pressure Injury Risk Assessment Tool was adequate (75%), while specificity was poor (40%). A moderate correlation was found between the Prevent Pressure Injury Risk Assessment Tool and the Braden Scale.ConclusionsThe Prevent Pressure Injury Risk Assessment Tool may be useful for identifying the adult pressure injury risk patients in acute care. Further research is needed to evaluate interrater reliability, and usability and validity with different patient populations.
Highlights
Pressure injures (PIs) are defined as localised injury to the skin and/or underlying tissue, usually over a bony prominence, as a result of pressure alone or in combination with shear [1]
A moderate correlation was found between the Prevent Pressure Injury Risk Assessment Tool and the Braden Scale
The Prevent Pressure Injury Risk Assessment Tool may be useful for identifying the adult pressure injury risk patients in acute care
Summary
Pressure injures (PIs) are defined as localised injury to the skin and/or underlying tissue, usually over a bony prominence, as a result of pressure alone or in combination with shear [1]. Various risk assessment instruments have been developed, including the Braden, Cubbin and Jackson, Norton, Ramstadius, and Waterlow scales, of which the Braden Scale has been most tested in a variety of care settings [15, 21]. It has been validated in several studies and has been found to be the best for identifying the patient’s PI risk [17] as well as being found to have good sensitivity and moderate specificity [21, 22] and moderate predictive validity [21]. The SRS appears to assess risk better than the Braden Scale, in particular, patients with low and moderate risk are better identified [24]
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