Identifying Candidate Predictors of Hospital-Acquired Pressure Injuries among Adult, Medical-Surgical Patients Using...

Area of Science:

• Clinical research
• Patient safety
• Medical informatics

Background:

• Hospital-acquired pressure injuries (HAPI) pose a significant threat to patient well-being and healthcare costs.
• Effective risk assessment is crucial for preventing HAPI.
• Existing prognostic models for HAPI require refinement through robust variable selection.

Purpose of the Study:

• To identify clinically significant candidate predictors of HAPI in adult medical-surgical patients.
• To establish a consensus among interdisciplinary clinicians on factors contributing to HAPI risk.
• To inform the development and improvement of HAPI risk assessment tools.

Main Methods:

• A modified Delphi technique involving an interdisciplinary expert panel of 16 clinicians.
• Multiple rounds of electronic questionnaires informed by a literature review of HAPI prognostic models.
• Panelists evaluated 205 concepts for clinical importance in HAPI risk assessment, categorizing them as predisposing or precipitating factors.

Main Results:

• 132 out of 205 (64%) concepts were deemed clinically important by the expert panel.
• Of the important concepts, 99 (75%) were predisposing factors and 33 (25%) were precipitating factors.
• 13 concepts achieved 100% agreement among the panelists.

Conclusions:

• Expert consensus identified a comprehensive list of 132 important concepts for HAPI risk assessment.
• This compilation serves as a foundation for creating new or enhancing existing HAPI risk assessment tools.
• Future research should validate these concepts as predictors and integrate them into standardized tools.