title: An instrument to measure healing in pressure ulcers: development and validation of the pressure ulcer scale for healing (PUSH).
abstract: BACKGROUND
  Currently, there is no instrument that provides an accurate and simple method of monitoring pressure ulcer healing in clinical practice. This article reports the two studies that were conducted to assess the validity of the Pressure Ulcer Scale for Healing (PUSH) as a tool to monitor healing of stage II-IV pressure ulcers.
  
  
  METHODS
  Subjects in both studies (N = 103 and N = 269) were elderly (mean Study 1, 75 years, mean Study 2, 80 years), and the majority were women (Study 1, 51%, Study 2, 70%). Study data were extracted from patients' permanent records.
  
  
  RESULTS
  Principal components analysis confirmed that the PUSH tool accounted for 58% to 74% of the wound healing variance over a 10-week period in Study 1 and 40% to 57% of the wound healing variance over a 12-week period in Study 2. In addition, multiple regression analysis, used to measure the sensitivity of the model to total healing, showed PUSH accounted for 39% of the variance in 6 weeks and 31% of the variance over 12 weeks (p <.001; Studies 1 and 2, respectively).
  
  
  CONCLUSIONS
  Data from these two studies confirmed that the PUSH tool, with the components of length times width, exudate amount, and tissue type, is a valid and sensitive measure of pressure ulcer healing. It is a practical approach that provides clinically valid data regarding pressure ulcer healing. Further testing is needed to confirm these findings.
authors.affiliation: School of Nursing, University of California-San Francisco, CA 94143-0610, USA. nancy.stotts@nursing.ucsf.edu
authors.forename: N A
authors.initials: NA
authors.lastname: Stotts
authors.forename: G T
authors.initials: GT
authors.lastname: Rodeheaver
authors.forename: D R
authors.initials: DR
authors.lastname: Thomas
authors.forename: R A
authors.initials: RA
authors.lastname: Frantz
authors.forename: A A
authors.initials: AA
authors.lastname: Bartolucci
authors.forename: C
authors.initials: C
authors.lastname: Sussman
authors.forename: B A
authors.initials: BA
authors.lastname: Ferrell
authors.forename: J
authors.initials: J
authors.lastname: Cuddigan
authors.forename: J
authors.initials: J
authors.lastname: Maklebust
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D003668:Pressure Ulcer / Q000503:physiopathology*; D025341:Principal Component Analysis; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014945:Wound Healing