A risk assessment scale for pressure ulcers in children

A risk assessment scale for pressure ulcers in children. nursingtimes.net. Aim:To develop a pressure ulcer risk assessment scale for children using statistical methods and patient data. Method:Data on 336 children admitted to 11 hospitals was collected using questionnaires. The data was studied to compare the characteristics of children who had developed pressure ulcers with the characteristics of the representative sample of hospitalised children. The significance of the children's characteristics in the development of pressure ulcers was then estimated and a risk assessment scale developed. Results:Using the significance values as a guide, the Glamorgan Paediatric Pressure Ulcer Risk Assessment Scale was developed. High weightings were assigned to immobility and pressure on the skin, but a lower weighting was given to anaemia. At a risk score of 10 the scale was 100% sensitive but 50.2% specific. It is difficult to assess true sensitivity and specificity due to the impact of preventive measures. At a risk score of 15, the scale was 98.4% sensitive and 67.4% specific. The area under the ROC curve was found to be 0.912, giving the Glamorgan scale a predictive validity of 91.2%. Discussion:The Glamorgan scale appears to be the first paediatric pressure ulcer risk assessment scale developed statistically using patient data. The sensitivity, specificity and predictive validity of the Glamorgan scale appears to be greater than the Braden Q scale, but testing with new data sets is required. Conclusion:The Glamorgan scale may give a more accurate estimate of risk than other scales, but it is important to note that no risk assessment scale can be 100% accurate. Nurses should examine and try to resolve the individual problems that contribute to the total risk.