Predictive validity of 4 risk assessment scales for prediction of pressure ulcer development in a hospital setting.
نویسندگان
چکیده
OBJECTIVES The aims of this study were to examine and compare the predictive validity of 4 risk assessment scales used for the prediction of pressure ulcer (PrU) development and to identify risk factors. DESIGN Cross-sectional descriptive study. SETTING A general hospital in Sweden. PARTICIPANTS Patients (all aged ≥18 years) admitted to medical, surgical, orthopedic, oncology, and rehabilitation wards. Of 412 patients available, a total of 346 patients participated in the study. METHOD Data were collected using the Swedish version of the European Pressure Ulcer Advisory Panel minimum data set as well as the Norton, Modified Norton, Braden, and Risk Assessment Pressure Sore (Ulcer) (RAPS) scales. The predictive validity was estimated by measuring sensitivity, specificity, positive predictive value, and negative predictive value. Multiple logistic regression analysis was used to determine risk factors associated with PrUs. RESULTS The RAPS scale reached best balance between sensitivity and specificity at the recommended cutoff level of ≤29, followed by the Braden scale and the Norton scale at recommended cutoff levels ≤18 versus ≤16, respectively. The modified Norton scale also reached an acceptable balance between sensitivity and specificity but at the cutoff level of ≤23, which is a higher cutoff level than recommended. General physical condition, physical activity, moisture, friction, and shear emerged as significant risk factors. CONCLUSIONS The results support that the recommended cutoff levels of the RAPS, Norton, and Braden scales are valid in a general hospital setting. However, the recommended cutoff level of the modified Norton scale (≤20) has to be increased when used in this care context.
منابع مشابه
Predictive values of Braden and waterlow scales to assess the risk of pressure ulcer : Review article
Introduction: Pressure ulcer is a kind of skin disorder that is developed due to increase of localized pressure on a part of body. Due to the terrible consequences of pressure ulcer, it is essential to prevent it. A common method to prevent is using risk assessment scales. The aim of this review study is to identify the best risk assessment to prevent and reduce the incidence of pressure ulcer....
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ورودعنوان ژورنال:
- Advances in skin & wound care
دوره 27 2 شماره
صفحات -
تاریخ انتشار 2014