Highlights
- •New skin risk assessment scale developed for use across all age groups.
- •Easy to use and includes device-related pressure injury risk.
- •Includes clinical decision support for evidence-based pressure injury prevention interventions.
- •Demonstrates validity and reliability for risk assessment across all age groups.
- •Successfully implemented in an electronic health record at Midwest Children's Hospital.
Abstract
Objectives
To describe the development of a new skin risk assessment scale called Skin Injury
Risk Assessment and Prevention (SIRA + P) and to establish initial reliability and validity of the scale among patients ranging
in age from birth, including pre-term, to adulthood, regardless of age or acuity of
illness.
Study Design
The single-site study was a retrospective chart review to evaluate the measurement
properties of SIRA + P. Charts of 385 patients of all ages and in all units (including the neonatal and
pediatric intensive care units) of a free-standing children's hospital were included.
Concurrent validity was assessed with scales having previously established reliability
and validity. For subjects <30 days of age, the comparison scale was the Neonatal Skin Risk Assessment Scale (NSRAS);
for subjects 31 days through 17 years, the Braden Q Scale (Braden Q) was used; and for subjects 18 years and older, the Braden Scale (Braden) was used. Interrater reliability was examined
using Intraclass Correlation Coefficients (ICC). Concurrent validity procedures compared
SIRA + P with NSRAS, Braden Q, and Braden using Pearson Correlation Coefficients.
Results
Interrater reliability for SIRA + P was very high (0.878). SIRA + P strongly correlated with the NSRAS (0.725), the Braden Q (−0.634), and the Braden (−0.778).
Conclusion
SIRA + P is designed to be used within the EHR and includes nursing decision support to guide
pressure injury prevention interventions for specific skin integrity risks. SIRA + P has good interrater reliability, is valid across all age groups and accounts for
device-related pressure.
Keywords
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Article info
Publication history
Published online: January 14, 2017
Accepted:
December 31,
2016
Received in revised form:
December 30,
2016
Received:
October 10,
2016
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
