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Evaluating the accuracy of impaired skin integrity in critically ill patients: Key characteristics and clinical
Alana Gomes Araújo de Almeida1, Lívia Maia Pascoal2, Paula Vitória Costa Gontijo3
1Graduate Program in Public Health, Federal University of Maranhão, São Luís, Brazil.
Objective:
To evaluate the accuracy of the defining characteristics of the nursing diagnosis Impaired skin integrity (00046) in patients admitted to intensive care units (ICUs).
Methods:
A cross-sectional diagnostic accuracy study was conducted with 105 adult patients admitted to an ICU. A latent class model with random effects was used to test the sensitivity and specificity of the defining characteristics investigated. The diagnosis Impaired skin integrity (00046) was the dependent variable, whereas sociodemographic and clinical data were the independent variables.
Results:
Impaired skin integrity was present in 3.75% of the sample. The defining characteristic with the best accuracy for the diagnosis was dry skin, with high sensitivity (0.9994) and specificity (0.9106). Other characteristics stood out in terms of sensitivity measures: altered skin color (0.9994) and foreign matter piercing skin (0.9994). In terms of specificity, the following stood out: desquamation (1.000), localized area hot to touch (0.9901), pruritus (0.9897), bleeding (0.9802), and hematoma (0.9208).
Conclusion:
The defining characteristics that helped infer the diagnosis Impaired skin integrity (00046) with greater certainty were dry skin, altered skin color, foreign matter piercing skin, desquamation, localized area hot to touch, pruritus, bleeding, and hematoma.
Implications For Nursing Practice:
Identifying defining characteristics with high diagnostic accuracy for Impaired skin integrity (00046) enables nurses to expand their clinical perspective on this dysfunction, which can affect the skin of critically ill patients, and to develop individualized care plans.
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