Psychometric evaluation of a new pressure ulcer skin risk assessment scale for the pediatric burn patient

dc.contributor.advisorAlice S. Hill, PhD, RN, FAANen_US
dc.contributor.committeeMemberSteven V. Owen, PhDen_US
dc.contributor.committeeMemberKathleen A. Nash, PhD, RNen_US
dc.contributor.committeeMemberDaniel L. Traber, PhDen_US
dc.contributor.committeeMemberCarolyn A. Phillips, RN, PhDen_US
dc.creatorMary D. Gordonen_US
dc.date.accessioned2011-12-20T16:05:04Z
dc.date.available2010-09-28en_US
dc.date.available2011-12-20T16:05:04Z
dc.date.created2009-07-24en_US
dc.date.issued2009-07-13en_US
dc.description.abstractPrevention of pressure ulcers is a primary goal in nursing practice, and achievement implies excellence in clinical care. One component of prevention is to understand the risk for pressure ulcer development. The benefit of knowing risk is to initiate pressure ulcer preventive interventions. Pressure ulcers are a significant problem in the pediatric burn patient population. Unfortunately, no skin risk assessment scale exist that capture the unique risk indices of the burn injury, thus the Pressure Ulcer Skin Risk Assessment Scale (PrUSRAS) was developed. The purpose of this study was to evaluate the validity, reliability and predictability of scores from the PrUSRAS. One hundred sixty-three burn patients from three pediatric burn Shriners Hospitals (Galveston, Cincinnati and Sacramento) were assessed with the PrUSRAS and followed to determine if pressure ulcers developed. The pressure ulcer incidence rate was 24.6%. Demographic data revealed significant findings: children who developed pressure ulcers had a higher mean percent burn injury (53%), increased number of mean hours in the operating room (>9 hours) and had a longer mean length of stay (46.7 days) compared to those children who did not develop pressure ulcers. Two estimates of reliability of PrUSRAS scores were computed: the intraclass correlation coefficient (ICC) and Cronbach’s coefficient alpha. The ICC calculation was 1.0. Cronbach’s coefficient alpha was low at 0.559. An exploratory factor analysis was used to assess construct validity. The analysis identified a 4-factor model, which was not readily interpretable. Logistic regression was used to predict the occurrence of pressure ulcers. Only three of the PrUSRAS items were significant predictors of pressure ulcers in the pediatric burn patients—percent burn, number of splints and prior or current pressure ulcers. The PrUSRAS is better at predicting children who will not get a pressure ulcer (95%) than it is at predicting those who will get a pressure ulcer (54%). Although this study did not provide evidence the PrUSRAS can identify risk of pressure ulcers in the pediatric burn patient the three significant pressure ulcer risk factors can be used in clinical practice to screen. \r\n \r\nen_US
dc.format.mediumelectronicen_US
dc.identifier.otheretd-07242009-104133en_US
dc.identifier.urihttp://hdl.handle.net/2152.3/186
dc.language.isoengen_US
dc.rightsCopyright © is held by the author. Presentation of this material on the TDL web site by The University of Texas Medical Branch at Galveston was made possible under a limited license grant from the author who has retained all copyrights in the works.en_US
dc.subjectskin risken_US
dc.subjectpressure ulcersen_US
dc.subjectpediatric burnen_US
dc.titlePsychometric evaluation of a new pressure ulcer skin risk assessment scale for the pediatric burn patienten_US
dc.type.genredissertationen_US
dc.type.materialtexten_US
thesis.degree.departmentNursingen_US
thesis.degree.grantorThe University of Texas Medical Branchen_US
thesis.degree.levelDoctoralen_US
thesis.degree.namePhDen_US

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