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NutriRisKids-ICU: Development and content validation of a nutritional risk screening tool for critically ill children
Verônica Ramos Souza1, Vanessa Camargo Trida1, Beatriz Polisel Mazzoni1
1Universidade de São Paulo - São Paulo, SP, Brazil.
Insights
A new nutritional risk screening tool, NutriRisKids-ICU, was developed for critically ill children in pediatric intensive care units (PICUs). Expert consensus validated its content, showing potential for clinical application.
Area of Science:
- Pediatric Intensive Care
- Clinical Nutrition
- Healthcare Tool Development
Background:
- Critically ill children in pediatric intensive care units (PICUs) face significant nutritional challenges.
- Early identification of nutritional risk is crucial for optimizing outcomes in pediatric intensive care.
- Existing screening tools may not adequately address the specific needs of critically ill pediatric populations.
Purpose of the Study:
- To develop and validate the content of a novel nutritional risk screening tool for critically ill children and adolescents.
- To create a reliable instrument for identifying patients at nutritional risk within the PICU setting.
- To establish a tool that integrates evidence-based practice with clinical expertise for pediatric nutritional assessment.
Main Methods:
- A care-convergent study design was employed for tool development and validation.
- The Delphi technique was used for content validation with expert consensus over two rounds.
- Content Validity Index (CVI) was calculated to ensure instrument validity, with a target of ≥0.70 for items and ≥0.90 overall.
Main Results:
- The developed tool, NutriRisKids-ICU, achieved a high overall Content Validity Index (CVI) of 0.958 after expert validation.
- The final tool incorporates key factors including age, chronic disease status, prior hospitalization, perceived malnutrition risk, admission nutritional therapy type, and C-reactive protein levels.
- Content validation involved two rounds of expert review, with initial adjustments made based on 18 experts and finalization by 12 experts.
Conclusions:
- The NutriRisKids-ICU tool was successfully developed and content-validated through expert consensus for critically ill pediatric patients.
- The tool effectively combines theoretical knowledge with clinical experience, demonstrating potential utility in PICUs.
- Further research is recommended to evaluate the practical applicability, sensitivity, and specificity of the NutriRisKids-ICU tool in clinical settings.
Objective:
The aim of this study was to develop and validate the content of a nutritional risk screening tool for critically ill children and adolescents in pediatric intensive care units (PICUs).
Methods:
Care-convergent study for the development and content validation of an instrument for assessing nutritional risk in children admitted to the PICU. The initial development was based on a literature review and the clinical experience of the authors. Content validation was conducted using the Delphi technique in two successive rounds with intentionally selected experts, each with a minimum of 5 years of experience in pediatric intensive nutritional therapy (NT). Consensus analysis was performed using the content validity index (CVI), with minimum values of 0.70 for individual items and 0.90 for the overall instrument.
Results:
Validation occurred in two rounds. In the first round, 18 experts suggested adjustments, and the revised version was reassessed by 12 experts in the second round. The final tool achieved an overall CVI of 0.958. The validated version included age subgroups, presence of chronic diseases, length of prior hospitalization, subjective impression of malnutrition risk, type of NT at admission, and C-reactive protein (CRP) levels.
Conclusions:
The nutritional risk screening tool for critically ill pediatric patients, named NutriRisKids-ICU, was developed, and its content was validated by expert consensus. The tool combines theoretical evidence and clinical expertise, showing potential for application in PICUs. However, further studies are needed to assess its applicability, sensitivity, and specificity.
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