Related Experiment Video
Updated: May 16, 2026
07:28
A Protocol of Manual Tests to Measure Sensation and Pain in Humans
Published on: December 19, 2016
Evaluating Pressure Ulcer Risk With PURPOSE T in Acute Care-Inter-Rater Reliability Between Registered Nurses and
Ulrika Källman1,2, Kerstin Ulin2,3, Lisa Hultin4,5
1Department of Research, Education and Innovation, Södra Älvsborg Hospital, Borås, Region Västra Götaland, Sweden.
International Wound Journal
|May 14, 2026
Summary
The Pressure Ulcer Risk Primary or Secondary Evaluation Tool (PURPOSE T) shows good reliability and usability for both registered nurses and assistant nurses in Sweden. Training is recommended for optimal use, with digital tools potentially enhancing assessments.
Area of Science:
- Nursing
- Patient Safety
- Clinical Assessment Tools
Background:
- Assistant nurses frequently conduct pressure ulcer risk assessments, yet prior validation studies often excluded them.
- The Pressure Ulcer Risk Primary or Secondary Evaluation Tool (PURPOSE T) is a critical instrument for evaluating patient risk.
- Understanding the reliability and usability of PURPOSE T across different nursing cadres is essential for consistent patient care.
Purpose of the Study:
- To evaluate the inter-rater reliability of the Swedish version of PURPOSE T between registered nurses and assistant nurses.
- To assess the usability of the Swedish PURPOSE T for both registered nurses and assistant nurses.
- To identify potential areas for improvement in the implementation and application of PURPOSE T.
Main Methods:
- A study involving 117 patients was conducted in three Swedish acute care hospitals from October 2022 to September 2023.
- Eight registered nurses and eight assistant nurses independently assessed patients in pairs using the paper-based PURPOSE T.
- Inter-rater reliability was measured using percentage agreement, simple kappa, and PABAK kappa statistics.
Main Results:
- The overall percentage agreement between registered nurses and assistant nurses was 86.6% (97/112).
- Simple kappa was 0.69 (95% CI 0.55-0.84) and PABAK kappa was 0.73 (95% CI 0.61-0.86), indicating good inter-rater reliability.
- Both nurse groups found PURPOSE T generally user-friendly, although specific items in Step 2 presented challenges.
Conclusions:
- The Swedish version of PURPOSE T demonstrates good inter-rater reliability and is perceived as user-friendly by both registered nurses and assistant nurses.
- Prioritizing education and training is crucial for optimizing the implementation of PURPOSE T in routine clinical practice.
- A digital version of PURPOSE T may offer enhanced facilitation and guidance compared to the current paper-based format.
Related Concept Videos
01:23Nurses' Legal Responsibilities II
Establishing a secure, collaborative nurse-patient relationship is crucial for delivering high-quality care. This relationship, founded on trust, respect, and honesty, enhances the patient's comfort and willingness to share vital health information. For example, a nurse who listens actively and without judgment provides clear information about health conditions and treatment options and respects patient decisions, which builds a trusting relationship.
Communication between nurses and patients...
Communication between nurses and patients...
01:09Accountability and Responsibility of a Nurse II
Professional accountability in nursing is a multifaceted concept that encompasses professional ethics, legal standards, and employment expectations. This framework ensures that nurses maintain and elevate the quality of care while upholding the values of their profession. It compels them to treat patients, families, and colleagues with respect, compassion, and integrity.
For example, a nurse demonstrating respect and compassion might listen attentively to a patient's concerns, provide comfort...
For example, a nurse demonstrating respect and compassion might listen attentively to a patient's concerns, provide comfort...
01:25Assessment of apical radial pulse
Apical-Radial (A-R) Pulse Assessment
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation
01:15Nursing Evaluation
The evaluation stage signals the end of the nursing process. The nurse gathers evaluative data to assess whether or not the patient has attained the expected results. Whereas the nurse collects data in the nursing assessment to identify the patient's health concerns, the evaluation stage data determines if the indicated health issues are resolved. Evaluative data collection includes two sections: the data acquired to evaluate patient outcomes and the time criteria for data collection.
Section...
Section...
01:30Accountability and Responsibility of a Nurse I
Accountability in nursing is a fundamental principle that underscores the obligation of nurses to take responsibility for their actions and answer for any errors or omissions in patient care. This principle is grounded in the professional, legal, and ethical frameworks that shape nursing practice. For instance, nurses must adhere to all relevant laws, regulations, and practice standards, including guidelines set forth by nursing boards and professional bodies, to ensure their actions comply...
01:26Peripheral Artery Disease IV: Nursing Management
The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses, temperature changes,...