Clinical validation of pressure ulcer risk factors

The maintenance of skin integrity is considered to be a survival need in the human need nursing framework. Risk factors for the nursing diagnosis High Risk For Impaired Skin Integrity: Pressure Ulcer were identified in a diagnostic content validity study. The purpose of this study was to use a pressure ulcer risk assessment instrument based on results of that study. The clinical validation model was used to analyze the ulcer risk factor cluster present in a sample of older adults residing in two nursing homes in the Mid-Atlantic region of the United States. A convenience sample of 108 residents were each assessed independently by two research assistants. Interrater reliability of the instrument was 93 percent. There were eight risk factors present in more than 60 percent of the subjects in the pressure ulcer group; six in the high risk group, and five in the low risk group. Findings suggest that three factors may be the best discriminators for pressure ulcer risk: (1) friction, (2) being dependent in self-care, and (3) being confined to bed/chair.