Evolution of a skin risk assessment tool: Determination of reliability and validity
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Type of Work78 pages
In the publication, Clinical Practice Guidelines for Pressure Ulcers in Adults, the Agency for Health Care Policy and Research made recommendations to use a validated skin risk assessment tool for the identification of patients at risk for development of pressure ulcers (AHCPR, 1992). Over the past ten years, Nanticoke Memorial Hospital (NMH) has screened all adult inpatients using a tool developed by the facility's Skin Care Committee. A recent prevalence study conducted at NMH by Hill-Rom International found a significantly lower percentage of acquired pressure ulcers at this facility as compared to the regional and national averages. Confident that the NMH Skin Risk Assessment Tool is effective, the researcher initiated a study to determine the degree of reliability and validity exhibited. Interrater reliability was measured by the completion of the NMH Tool by two certified Enterostomal Therapy Nurses (CETNs) on each patient within the sample (n=30). A Spearman Rank Order Correlation of .89 was found,with a significance level of .000, confirming the research hypothesis that the NMH Tool demonstrates interrater reliability. Determination of content validity involved the completion of a Content Relevance Scale by ten CETN experts. The Overall Content Validity Index (CVIl was calculated at 0.89, surpassing the researcher's pre-set CVI goal of 0.85. Concurrent validity was assessed by completion of the NMH Tool and the Braden Risk Assessment Scale on a second patient sample (n = 60). Spearman Rank Order Correlation was -0.93 for the overall paired scores with a significance level of .000. Based on the data analysis yielding the above CVI and Spearman Rho values, the NMH Skin Risk Assessment Tool was found to demonstrate acceptable levels of interrater reliability, content validity, and concurrent validity.