The Development Of Risk Assessment Tool For Perioperative Pressure Injury

ObjectiveTo develope a risk assessment tool for perioperative pressure injury which is adaptive to the adult patients' characteristic in our country,aims to provide refrences basis for nursing staff assessing risk factors of perioperative pressure injury.So as to help the nursing staff assessing the risk factors of perioperative pressure injury timely,accurately and dynamically,and take targeted preventive measures in time,in order to reduce the incidence of perioperative pressure injury and promote safety for patients.Methods1.Establishment of perioperative risk tool for pressure injury(adult).Through literatures reviewing,semi-structured interviews and referring to domestic and foreign pressure injury risk assessment scales,the item pool of perioperative pressure injury risk assessment scale was established,which included 3 primary items and 29 secondary items.After two rounds of items screened and modificated by Delphi experts consultation.The reliability and authority of experts were evaluated by positive coefficient,authority coefficient,coefficient of variation(CV),Kendall's and so on.The initial risk assessment tool for perioperative pressure injury included 3 primary items and 14 secondary items.2.The reliability and validity of the initial risk assessment tool for perioperative pressure.A total of 158 patients from a top-level hospital in Changsha,Hunan Province,were surveyed using a pre-test scale by convenient sampling method.Through the methods of project analysis,homogeneity analysis,vality analysis and reliability analysis,the items were further screened and formed the formal scale.Results1.Delphi expert consultation results.2 rounds of Delphi expert consultation were conducted in the study,All the selected experts were familiar with the knowledge related to pressure injury,who were having high academic authority and rich clinical experience.The experts' positive coefficients of two rounds were 92% and 91.9%,authority coefficients were 0.89 and 0.88.Kendall's concordance coefficients were 0.416 and 0.458,both of them were statistically significant(P<0.01).The preliminary assessment tool included 3 primary items and 14 secondary items.2.Perioperative pressure injury assement tool reliability and validity test results.The final perioperative pressure injury assement tool was established,including 3 dimensions and 11 secondary items.(1)Reliability test: the Cronbacha of the whole scale was 0.787 and 3 dimensions were 0.761,0.728 and 0.779;spilt-half reliability was 0.703;(2)Validity test:(1)Content validity: items were screened by 2 rounds Delphi expert consultation,the scale I-CVI was between 0.81~1,S-CVI was 0.94.(2)Construct validity: exploratory factor analysis extracted 3 common factors,and the cumulative variance contribution rate was 63.278%,and the factor load of each item was over 0.4.The correlation between three dimensions and the total score of the evaluation tool ranged from 0.616 to 0.883,the correlation coefficient between each dimension was between 0.210~0.468,both of them were statistically significant(P<0.01),indicating the assessment tool with good structural validity.Conclusion1.The preliminary perioperative pressure injury risk assessment tool was established.2.The assement tool possesses good reliability and validity,which has strong clinical applicability,and conforms to the characteristic of people in our country.