Pediatric pressure injuries: does modifying a tool alter the risk assessment outcome?

Area of Science:

• Pediatric Intensive Care
• Neonatal Nursing
• Patient Safety

Background:

• Pressure injuries pose a significant risk to vulnerable patients in intensive care settings.
• Accurate risk assessment tools are crucial for timely intervention and prevention strategies.
• Existing tools may require adaptation for specific pediatric and neonatal populations.

Purpose of the Study:

• To evaluate the modified Glamorgan Scale (mGS) for pressure injury risk assessment in Pediatric Intensive Care Units (PICU) and Neonatal Units (NNU).
• To compare the risk identification capabilities of the mGS against the standard Glamorgan Scale (GS).
• To assess the usability and effectiveness of the mGS in clinical practice.

Main Methods:

• Prospective data collection over a 2-month period.
• Assessment of 112 patients using both the mGS and GS.
• Risk scores determined through patient observation, record review, and nurse consultation.
• Chi-square analysis to compare risk category allocations between the two scales.

Main Results:

• Both the mGS and GS allocated most patients to 'High Risk' or 'Very High Risk' categories.
• There was minimal difference in risk category allocation between the mGS and GS (p=0.982).
• Only one patient was assigned a different risk category by the two tools; the mGS was found to be easier to complete.

Conclusions:

• The modified Glamorgan Scale (mGS) demonstrates comparable pressure injury risk identification to the Glamorgan Scale (GS) in PICU and NNU settings.
• The mGS is a viable and user-friendly alternative for assessing pressure injury risk in these critical care environments.
• Further research is needed to confirm agreement in the general pediatric population and understand the impact of modifications on outcomes.