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SIRA+P: Development and Testing

Kristina L Foster1, Lacey D Bergerhofer2, Janis B Smith2

  • 1Lucile Packard Children's Hospital Stanford, 725 Welch Rd, Palo Alto, CA 94304, United States.

Journal of Pediatric Nursing
|January 18, 2017
PubMed

Insights

The new Skin Injury Risk Assessment and Prevention (SIRA+P) scale demonstrates high reliability and validity across all ages for assessing skin injury risk. This tool aids nurses in preventing pressure injuries with EHR integration.

Area of Science:

  • Nursing
  • Patient Safety
  • Clinical Assessment Tools

Background:

  • Pressure injuries are a significant concern in healthcare, impacting patient outcomes and increasing costs.
  • Existing risk assessment scales may have limitations in applicability across diverse age groups and clinical settings.
  • The development of a comprehensive and reliable skin risk assessment tool is crucial for effective prevention strategies.

Purpose of the Study:

  • To introduce and evaluate the psychometric properties of the Skin Injury Risk Assessment and Prevention (SIRA+P) scale.
  • To establish the initial reliability and validity of the SIRA+P scale in a broad patient population, from neonates to adults.
  • To assess the SIRA+P scale's utility across various age groups and illness acuities.

Main Methods:

  • A retrospective chart review of 385 patients across all hospital units was conducted.
  • Concurrent validity was assessed by comparing SIRA+P with established scales: Neonatal Skin Risk Assessment Scale (NSRAS), Braden Q Scale (Braden Q), and Braden Scale.
  • Interrater reliability was determined using Intraclass Correlation Coefficients (ICC).

Main Results:

  • The SIRA+P scale exhibited very high interrater reliability (ICC = 0.878).
  • Strong correlations were found between SIRA+P and established scales: NSRAS (0.725), Braden Q (-0.634), and Braden (-0.778).
  • These results indicate good reliability and validity across the studied age spectrum.

Conclusions:

  • The SIRA+P scale is a reliable and valid tool for assessing skin injury risk in patients of all ages.
  • Designed for EHR integration, SIRA+P offers nursing decision support for targeted pressure injury prevention.
  • The scale's ability to account for device-related pressure enhances its clinical utility in preventing skin breakdown.
Abstract

Keywords:
Decision supportPressure injuryPressure ulcerRisk assessmentSkin injury

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