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Skin breakdown in acute care pediatrics.
Elizabeth C Suddaby1, Scott Barnett, Lorna Facteau
1Inova Fairfax Hospital for Children, Falls Church, VA, USA.
Pediatric Nursing
|June 7, 2005
Summary
The Starkid Skin Scale aids nurses in identifying pediatric patients at risk for skin breakdown. This tool shows high specificity for predicting skin breakdown in hospitalized children.
Area of Science:
- Pediatric Nursing
- Dermatology
- Healthcare Technology
Background:
- Hospitalized children are susceptible to skin breakdown.
- Effective risk assessment tools are crucial for prevention.
- Existing tools may not be optimized for pediatric populations.
Purpose of the Study:
- To develop and validate the Starkid Skin Scale, a single-page tool for assessing skin breakdown risk.
- To apply the scale to acutely hospitalized children.
- To evaluate the scale's predictive ability for skin breakdown.
Main Methods:
- Data collected from 347 pediatric patients across four in-patient units over 15 months.
- Skin breakdown assessed using AHCPR staging guidelines.
- Starkid Skin Scale scores compared to breakdown incidence to determine predictive accuracy.
Main Results:
- Starkid Skin Scale demonstrated high inter-rater reliability (r2 = 0.85) and good internal reliability (0.71).
- The scale showed low sensitivity (17.5%) but high specificity (98.5%) in predicting skin breakdown.
- Prevalence of skin breakdown was 23%, with erythema being the most common form. Occiput and buttocks were common sites.
Conclusions:
- The Starkid Skin Scale can assist pediatric nurses in identifying high-risk patients needing intensive prevention.
- Further research is necessary to determine the efficacy of specific prevention strategies for pediatric skin breakdown.