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Pressure Injury Risk Assessment in Pediatric Intensive Care: A Prospective Validation Study of the Glamorgan Scale
Marcelli Christine Vocci1, Hélio Amante Miot, Cassiana Mendes Bertoncello Fontes
1Marcelli Cristine Vocci, MSc, NP, is PhD candidate, São Paulo State University, Botucatu, São Paulo, Brazil. Hélio Amante Miot, PhD, MD, is Full Professor, Dermatology Department, UNESP Medical School, São Paulo. Cassiana Mendes Bertoncello Fontes, PhD, NP, is Associate Professor, Department of Nursing, São Paulo State University. Luciana Patricia Fernandes Abbade, PhD, MD, is Full Professor, Department of Infectious Diseases, Dermatology, Diagnostic Imaging, and Radiotherapy, UNESP Medical School.
Insights
The Glamorgan Scale effectively assesses pressure injury risk in pediatric intensive care units (PICU), showing accuracy comparable to the Braden Q Scale. This validation confirms its reliability for critically ill children.
Area of Science:
- Pediatric critical care medicine
- Nursing research
- Patient safety
Background:
- Pressure injuries are a significant concern in pediatric intensive care units (PICUs).
- Accurate risk assessment tools are crucial for preventing pressure injuries in vulnerable pediatric populations.
- The Glamorgan Scale is a tool for assessing pressure injury risk.
Purpose of the Study:
- To validate the Glamorgan Scale for use in a pediatric intensive care unit (PICU).
- To compare the predictive accuracy of the Glamorgan Scale against the Braden Q Scale for pressure injury risk in pediatric patients.
Main Methods:
- A prospective cohort study involving 83 patients and 639 measurements in a PICU.
- Psychometric properties of the Glamorgan Scale were assessed, including reliability and validity (concurrent and predictive).
- The Braden Q Scale was used for comparative predictive analysis.
Main Results:
- The Glamorgan Scale demonstrated satisfactory predictive validity (Area Under Curve = 0.77).
- The Braden Q Scale showed similar predictive performance (Area Under Curve = 0.78).
- A strong correlation was found between Glamorgan Scale total scores (ρ = -0.76, P < .01), supporting its validation.
Conclusions:
- The Glamorgan Scale is validated and suitable for pressure injury risk assessment in critically ill pediatric patients in Brazil.
- The scale exhibits good accuracy and consistency.
- Its predictive accuracy is comparable to the Braden Q Scale.
Objective:
To validate the Glamorgan Scale and compare its predictive ability in assessing pressure injury risk among patients in a pediatric ICU (PICU) with that of the Braden Q Scale.
Methods:
A prospective cohort study was performed to validate the Glamorgan Scale and compare its predictive ability with the Braden Q Scale in a PICU population. A total of 83 patients admitted in the PICU between February and July 2020 met the inclusion criteria and were included in the study, leading to 639 measurements. The authors tested the psychometric properties of the Glamorgan Scale to validate whether the characteristics of the original version were preserved. To this end, reliability (internal consistency) and concurrent and predictive validity (sensitivity and specificity) were assessed. For the predictive comparison, the authors performed the same tests with the Braden Q Scale.
Results:
The predictive validity, as assessed by the receiver operator characteristic curve and calculation of the area under the curve, showed satisfactory performance for the Glamorgan Scale (0.77; CI, 0.72-0.82); the Braden Q Scale values were similar (0.78; CI 0.73-0.84). The Spearman correlation coefficient showed a strong correlation between the total scores of the Glamorgan Scale (ρ = -0.76; P < .01), corroborating its validation.
Conclusions:
The Glamorgan Scale was validated and showed good accuracy and consistency for pressure injury risk assessment in critically ill pediatric patients in Brazil. Its accuracy was similar to that of the Braden Q Scale.
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