A Comparative Study Of Two Scales In Predicting The Risk Of Pressure Injury In ICU Patients

Objective:To compare the risk of skin pressure injury in ICU patients by Cubbin&Jackson assessment scale and Waterlow assessment scale,and to select a scale for comprehensive assessment of pressure injury in ICU patients,which is the risk of pressure injury in clinical ICU patients.The selection of rating scales provides a theoretical basis.Methods:The study subjects selected 120 inpatients of the Department of Critical Care Medicine from July 20 to December 2018 in a third-grade hospital in Taiyuan City.For inpatients who met the study criteria,the Waterlow Scale and the Cubbin&Jackson Scale were used to complete the first assessment of pressure injuries within 2 hours of admission,and were assessed daily thereafter,in the event of pressure injury,death,discharge,or transfer.The assessment is terminated and the patient is recorded for pressure injury and its stage,location and time of occurrence.Statistical analysis was performed on the data using SPSS 22.0 data analysis software.Results:(1)Through 120 patients who met the exclusion criteria,26 subjects underwent pressure injury during the study period.Among them,18 cases of stage 1 pressure injury(69.23%),all returned to normal within 12 hours after the implementation of nursing measures;8 cases of pressure injury in stage 2(30.77%),all are inevitable stress injuries,inevitable stress The incidence of sexual injury was 6.67%.The high-risk part of the pressure injury is the appendix,followed by the heel.(2)In the six dimensions of age,nutritional status,tissue malnutrition,control ability,exercise capacity and nutritional deficiencies,the Waterlow scale scored higher in the pressure injury group than in the no-pressure injury group;the Cubbin & Jackson scale in the weight status,individual Among the nine dimensions of self-care ability,breathing,mental state,oxygen demand status,skin condition,hemodynamic status,incontinence and activity,the pressure injury group score was lower than that of the no-pressure injurygroup.(3)Using the Waterlow scale to evaluate the risk factors of pressure injury in ICU hospitalized patients,the ideal diagnostic boundary value of the scale is 22,the corresponding sensitivity is 52.10%,the specificity is 61.50%,and the positive predictive value is 26.22.%,the negative predictive value is 83.05%.The Cubbin&Jackson scale was used to evaluate the risk factors of pressure injury in ICU hospitalized patients.The ideal diagnostic boundary value of the scale was 29,the corresponding sensitivity was 85.10%,the specificity was 69.20%,and the positive predictive value was 44.90%.The predicted value is 94.36%.The area under the ROC curve for the Waterlow Scale and the Cubbin &Jackson Scale are 0.507 and 0.832,respectively.Conclusion:(1)Critically ill patients are high-risk groups in hospitals with stress injuries.Nursing staff should evaluate the risk factors of pressure injury and take corresponding measures to reduce the occurrence of stress injuries.(2)The sensitivity and specificity of the Waterlow scale evaluation tool are not ideal.The sensitivity,specificity,Youden index,and area under the ROC curve of the Cubbin &Jackson scale are higher,and the prediction effect is better.