Developing a pressure ulcer risk assessment scale for patients in long-term care.
Previous pressure ulcer risk assessment scales appear to have relied on opinions about risk factors and are based on care setting rather than research evidence. Utilizing 21 existing risk assessment scales and relevant risk factor literature, an instrument was developed by Finnish researchers that takes into account individual patient risk factors, devices and methods applied in nursing care, and organizational characteristics. The instrument underwent two pilot tests to assess the relevance and clarity of the instrument: the first involved 43 nurses and six patients; the second involved 50 nurses with expertise in wound care. Changes to questionnaire items deemed necessary as a result of descriptive analysis and agreement percentages were completed. After pilot testing, the final instrument addressed the following issues: 1) patient risks: activity, mobility in bed, mental status, nutrition, urinary incontinence, fecal incontinence, sensory perception, and skin condition; 2) devices and methods used in patient care: technical devices, bed type, mattress, overlay, seat cushions, and care methods; and 3) staff number and structure, maximum number of beds, and beds in use (the last group of questions were included to ensure participants understood the items; results were not analyzed). The phases of the study provided an expeditious means of data collection and a suitable opportunity to assess how the instrument would function in practice. Instrument reliability and validity were improved as a result of the pilot testing and can be enhanced further with continued use and assessment.
Lepisto
Mervi
M
Laurea Polytechnic Hyvinkää Institute, Hyvinkää, Finland. Karkonmäenkatu 15 b, Fin-33580 Tampere, Finland. mervi.lepisto@laurea.fi
Eriksson
Elina
E
Hietanen
Helvi
H
Lepisto
Jyri
J
Lauri
Sirkka
S
D000203:Activities of Daily Living; D000328:Adult; D001291:Attitude of Health Personnel; D001509:Bed Occupancy; D001513:Beds; D002983:Clinical Competence / Q000592:standards; D003625:Data Collection; D005242:Fecal Incontinence / Q000150:complications; D005387:Finland; D006786:Hospitals, Urban; D006801:Humans; D008134:Long-Term Care / Q000458:organization & administration; D016743:Mental Competency; D009730:Nursing Assessment / Q000458:organization & administration*; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000523:psychology / Q000600:supply & distribution; D009752:Nutritional Status; D010561:Personnel Staffing and Scheduling; D010865:Pilot Projects; D003668:Pressure Ulcer / Q000175:diagnosis* / Q000209:etiology / Q000451:nursing; D018570:Risk Assessment / Q000458:organization & administration*; D012307:Risk Factors; D014549:Urinary Incontinence / Q000150:complications