title: The development and testing of a skin tear risk assessment tool.
abstract: The aim of the present study is to develop a reliable and valid skin tear risk assessment tool. The six characteristics identified in a previous case control study as constituting the best risk model for skin tear development were used to construct a risk assessment tool. The ability of the tool to predict skin tear development was then tested in a prospective study. Between August 2012 and September 2013, 1466 tertiary hospital patients were assessed at admission and followed up for 10 days to see if they developed a skin tear. The predictive validity of the tool was assessed using receiver operating characteristic (ROC) analysis. When the tool was found not to have performed as well as hoped, secondary analyses were performed to determine whether a potentially better performing risk model could be identified. The tool was found to have high sensitivity but low specificity and therefore have inadequate predictive validity. Secondary analysis of the combined data from this and the previous case control study identified an alternative better performing risk model. The tool developed and tested in this study was found to have inadequate predictive validity. The predictive validity of an alternative, more parsimonious model now needs to be tested.
authors.affiliation: Research Department, Silver Chain Group, Osborne Park, WA, Australia.|School of Nursing and Midwifery, Curtin University, Perth, WA, Australia.
authors.forename: Nelly
authors.initials: N
authors.lastname: Newall
authors.affiliation: Research Department, Silver Chain Group, Osborne Park, WA, Australia.|School of Nursing and Midwifery, Curtin University, Perth, WA, Australia.
authors.forename: Gill F
authors.initials: GF
authors.lastname: Lewin
authors.affiliation: Institute for Health Research, University of Notre Dame, Fremantle, WA, Australia.
authors.forename: Max K
authors.initials: MK
authors.lastname: Bulsara
authors.affiliation: Research Department, Silver Chain Group, Osborne Park, WA, Australia.|School of Nursing and Midwifery, Curtin University, Perth, WA, Australia.
authors.forename: Keryln J
authors.initials: KJ
authors.lastname: Carville
authors.affiliation: School of Nursing and Midwifery, Curtin University, Perth, WA, Australia.
authors.forename: Gavin D
authors.initials: GD
authors.lastname: Leslie
authors.affiliation: School of Nursing and Midwifery, Curtin University, Perth, WA, Australia.
authors.forename: Pam A
authors.initials: PA
authors.lastname: Roberts
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019937:Diagnostic Techniques and Procedures; D005260:Female; D006801:Humans; D022125:Lacerations / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011594:Psychometrics / Q000379:methods*; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012867:Skin / Q000293:injuries*
keywords: Prospective cohort study; Risk assessment; Skin tears