title: Category I pressure ulcers: how reliable is clinical assessment?
abstract: BACKGROUND
  Pressure ulcer prevention is an indicator of quality of care. Reliable identification of Category I pressure ulcers is essential in prevalence studies and to prevent further tissue damage.
  
  
  OBJECTIVE
  The primary purpose of this study was to establish interrater reliability between blanching and nonblanching erythema assessed by 2 independent assessors. The secondary purpose was to investigate potential correlations between risk factors and pressure ulcers.
  
  
  METHODS
  Ninety-seven patients 65 years or older with hip fractures were consecutively recruited for this prospective, comparative observation study. Seventy-eight patients completed the study. The sacral area of each patient was visually assessed and a finger-press test was administered to each patient by 2 independent assessors. Kappa statistics were used for analysis.
  
  
  RESULTS
  finger-press tests and visual observation alone were not reliable methods to discriminate between blanching and nonblanching erythema. Forty-seven percent of the patients had a risk score 20 or fewer (high risk for pressure ulcers). Forty-four patients (56%) had pressure ulcers at discharge.
authors: Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden at Karolinska University Hospital, Stockholm, Sweden.
authors: E
authors: E
authors: Sterner
authors: C
authors: C
authors: Lindholm
authors: E
authors: E
authors: Berg
authors: A
authors: A
authors: Stark
authors: B
authors: B
authors: Fossum