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The development of the Glamorgan paediatric pressure ulcer risk assessment scale
J Willock1, M M Baharestani, D Anthony
1Faculty of Health and Sports Sciences, University of Glamorgan, UK.
Insights
A new risk assessment scale, the Glamorgan paediatric pressure ulcer scale, was developed using patient data. This scale demonstrates superior predictive validity for pressure ulcers in children compared to existing tools.
Area of Science:
- Paediatric Nursing
- Clinical Risk Assessment
- Dermatology
Background:
- Pressure ulcers pose a significant risk to paediatric inpatients.
- Existing risk assessment tools for pressure ulcers are often adapted from adult populations.
- There is a need for a validated, paediatric-specific pressure ulcer risk assessment scale.
Purpose of the Study:
- To develop and validate a novel pressure ulcer risk assessment scale tailored for paediatric patients.
- To identify key patient characteristics associated with pressure ulcer development in children.
Main Methods:
- Data collection via detailed questionnaires from 265 paediatric inpatients and 71 children with/without pressure ulcers across 11 hospitals.
- Statistical analysis (chi-square test) to compare characteristics of children with and without pressure ulcers.
- Development of the Glamorgan paediatric pressure ulcer risk assessment scale based on significant variables.
Main Results:
- The Glamorgan paediatric pressure ulcer risk assessment scale was successfully developed.
- Significant risk factors identified include: difficult positioning, anaemia, skin friction from equipment, reduced mobility, prolonged surgery, and persistent pyrexia.
- The Glamorgan scale exhibited superior sensitivity, specificity, and predictive validity compared to the Braden Q scale.
Conclusions:
- Developing risk assessment tools using paediatric-specific data is advantageous over modifying adult tools.
- The Glamorgan scale offers a more accurate and reliable method for assessing pressure ulcer risk in children.
- Implementation of the Glamorgan scale can potentially improve patient outcomes and reduce pressure ulcer incidence in paediatric care.
Objective:
To develop a predictive pressure ulcer risk assessment scale based on patient data.
Method:
Detailed questionnaires, based on a review of the paediatric and adult literature and discussion with paediatric nurses with expertise in this area, were used to obtain data on patient characteristics from 265 inpatients in a children's hospital and 54 children with pressure ulcers and 17 children without pressure ulcers from 11 hospitals. These data were then combined to compare the characteristics of children with and without pressure ulcers (using the chi-square test).
Results:
The Glamorgan paediatric pressure ulcer risk assessment scale was developed, based on the significance values identified by the statistical analysis. Variables that were significantly (p<0.01) associated with pressure ulceration included: difficult to position, anaemia, equipment pressing or rubbing against skin, reduced mobility for age, prolonged surgery and persistent pyrexia. The sensitivity, specificity and predictive validity of the Glamorgan scale was found to be greater than those for the Braden Q scale, which is widely used to assess pressure ulcer risk in children in the US.
Conclusion:
Using patient data from children and young people in the development of risk assessment tools for this age group may be preferable to modifying existing adult tools.
