Development and Preliminary Validation of a Central Venous Access Device-Associated Skin Impairment Classification...

Area of Science:

• Medical Device Technology
• Dermatology
• Nursing Research

Background:

• A standardized, evidence-based instrument is crucial for classifying skin impairments associated with central venous access devices (CVADs).
• Current classification methods lack consensus, leading to potential inconsistencies in patient care.
• The need for a reliable tool to address CVAD-related skin issues is evident in clinical practice.

Purpose of the Study:

• To design and validate a novel classification tool for central venous access device-associated skin impairments.
• To establish a common language for healthcare professionals in assessing and managing these skin conditions.
• To improve diagnostic accuracy and clinical decision-making related to CVAD skin complications.

Main Methods:

• A two-phase modified Delphi study methodology was employed.
• Phase 1 involved a literature review and the development of the classification instrument by experts in CVADs and wound management.
• Phase 2 included validation using clinical photographs and assessment of content validity and inter-rater reliability by an expert panel.

Main Results:

• The developed instrument features five primary etiological classifications (contact dermatitis, mechanical injury, infection, pressure injury, complex clinical presentation) and 14 subcategories with definitions.
• High agreement was achieved for preliminary scale content validity and item content validity (I-CVI=1).
• Excellent inter-rater reliability was demonstrated for both the etiological classifications and the individual definitions/signs and symptoms.

Conclusions:

• The developed and validated classification tool offers a standardized approach to assessing CVAD-associated skin impairments.
• This common language is expected to reduce clinical uncertainty, misdiagnosis, and mismanagement.
• The tool will enhance clinical decision-making, leading to improved treatment quality and patient outcomes.