Development and Psychometric Evaluation of a Medical Device-Related Pressure Injury Risk Assessment Scale.

Area of Science:

• Nursing
• Patient Safety
• Medical Devices

Background:

• Medical device-related pressure injuries pose a significant patient safety risk.
• Existing risk scales inadequately address device-specific factors in adults.
• A need exists for a standardized tool to identify at-risk patients.

Purpose of the Study:

• To develop and psychometrically evaluate a standardized risk assessment scale for medical device-related pressure injuries in hospitalized adults.
• To improve the identification of patients at risk for these preventable injuries.

Main Methods:

• Literature review and expert consensus generated initial items.
• Content validity assessed using the Davis technique (CVI=0.96).
• Scale administered to 160 adult patients with medical devices; psychometric properties evaluated using logistic regression, factor analysis, and ROC analysis.

Main Results:

• The Medical Device-Related Pressure Injury Risk Assessment Scale (MedRAS) demonstrated strong discrimination (AUC=0.844) with an optimal cutoff of 14.5.
• Exploratory factor analysis revealed a two-factor structure (Device/Mechanical, Patient/Tissue Factors).
• The scale exhibited good internal consistency (Cronbach's alpha=0.80) and excellent inter-rater reliability (Cohen's kappa=0.806).

Conclusions:

• The developed MedRAS scale is a valid and reliable tool for identifying hospitalized adults at risk for medical device-related pressure injuries.
• This device-focused scale can support early risk identification and targeted nursing interventions.
• Implementation has the potential to enhance patient safety and care quality in inpatient and critical care settings.