At risk of pressure ulcers - a nursing diagnosis

Abstract

Aim: The aim of the study was content validation of the nursing diagnosis of at Risk of Impaired Skin Integrity by a sample of Slovak nurse-experts. It focuses on identifying the major risk factors in pressure ulcer development. Design: Retrospective study. Methods: The Diagnostic Content Validity Model designed by Fehring was used for validation of the nursing diagnosis; we used it to establish the significance of the risk factors of the nursing diagnosis of at Risk of Impaired Skin Integrity in relation to pressure ulcer development. Correlation analysis was used for evaluation of the relationships between the risk factors. The sample consisted of 126 nurse-experts in accordance with modified Fehring criteria. Results: Out of 23 items, the nurses rated nine as significant (the most frequently present) risk factors (the weighted scores are shown in brackets): physical immobilisation (0.92), skeletal prominence (0.9), imbalanced nutritional state (0.86), moisture (0.86), mechanical factors (e.g., shearing forces, pressure, restraint) (0.84), a Norton Scale score of 14 ≥ points (0.81), hyperthermia (0.81), excretions (0.77), and extremes of age (0.76). Statistically significant correlations, which are positive and range between 0.2 and 0.4, were found between some risk factors. The strongest correlations were found between moisture and mechanical factors (r = 0.4008) and moisture and physical immobilization (r = 0.3072). Conclusion: Using the DCV model, the experts identified nine significant risk factors which can be predictors of pressure ulcer development.

Keywords

• pressure ulcers
• validation
• potential nursing diagnosis
• risk factors