Predicting Neonatal Skin Injury: The First Step to Reducing Skin Injuries in Neonates

Area of Science:

• Neonatal intensive care unit (NICU) care
• Pediatric dermatology
• Clinical risk assessment tools

Background:

• Skin injuries are a common problem for neonates in the NICU.
• Predicting which neonates are at risk of skin injury is crucial for prevention.
• Limited evidence exists on the superiority of different predictive tools.

Purpose of the Study:

• To evaluate the predictive value of the Skin Risk Assessment and Management Tool (SRAMT).
• To compare the SRAMT's performance against the Neonatal/Infant Braden-Q Scale (BQS) and healthcare staff's predictions.
• To identify the most effective tool for predicting neonatal skin injury risk.

Main Methods:

• A prospective study was conducted from November to December 2016.
• The Skin Risk Assessment and Management Tool (SRAMT) was evaluated.
• Data included gestation, weight, assessment day, injury types, causation, medical devices, and risk scores; comparisons were made with BQS and staff predictions.

Main Results:

• 248 assessments were completed; 38% of neonates experienced skin injuries.
• The SRAMT demonstrated a higher Area Under the Curve (AUC) of 0.94 (0.02) compared to BQS's 0.82 (0.03).
• SRAMT showed superior sensitivity (90.0%) and specificity (88.46%) compared to BQS (72.86% and 79.23%, respectively).

Conclusions:

• The SRAMT is more effective in predicting neonates at risk of skin injury than the Neonatal BQS and staff.
• Predicting neonatal skin injuries is a complex, multifactorial issue.
• The findings support the use of SRAMT for improved risk assessment in NICU settings.