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Development and validation of an ICU-specific pressure injury risk assessment scale
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Region Kalmar county, Sweden.ORCID iD: 0000-0002-9679-8461
Linköping University, Sweden.
Linköping University, Sweden.
Linköping University, Sweden;University Hospital Linköping, Sweden.
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2021 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 35, no 3, p. 769-778Article in journal (Refereed) Published
Abstract [en]

Background Critically ill patients are at high risk for pressure injury (PI) due to critical illness combined with multiple interventions and therapies. It is hence important to gain more knowledge about the risk factors associated with pressure injury development and methods for decreasing its prevalence. Aims To develop and validate a clinical useful ICU-specific PI risk assessment scale based on the RAPS. Method The study was designed as a prospective instrument development and validation study. The Risk Assessment Pressure Ulcer Scale (RAPS), which in Sweden is a commonly used PI risk assessment scale, was used as a starting point. Development was then performed in different steps; adaption of items and response options to ICU care, discussion with ICU staff members to enhance clinical relevance and usability, test of interrater reliability, revision of instrument, a new test with 300 patients followed by statistical evaluation. Results The final version of the RAPS-ICU consists of six items: failure of vital organs, mobility, moisture, sensory perception, level of consciousness and special treatment in the form of mechanical ventilation, continuous dialysis and/or inotropic drugs. A total score was reached by summing all responses. Each of the items was found to be significant associated with PI development as well as the total score (p < 0.001). The total score also showed a high interrater reliability (ICC = 0.96), good sensitivity and acceptable specificity with AUC = 0.71 and ICU staff perceived the RAPS-ICU as relevant and easy to use in clinical practice. Conclusion The RAPS-ICU is a valid and clinically useful tool to identify patients at risk to develop pressure injury at ICU.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021. Vol. 35, no 3, p. 769-778
Keywords [en]
pressure ulcer, pressure injury, intensive care, critical care, risk assessment, instrument development, pressure ulcer prophylaxis, prevention, nursing
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
URN: urn:nbn:se:lnu:diva-97666DOI: 10.1111/scs.12891ISI: 000548420900001PubMedID: 32666602Scopus ID: 2-s2.0-85087833230Local ID: 2020OAI: oai:DiVA.org:lnu-97666DiVA, id: diva2:1461299
Available from: 2020-08-26 Created: 2020-08-26 Last updated: 2023-04-17Bibliographically approved

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Wåhlin, IngridÅrestedt, Kristofer

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