Coleman S, Smith IL, McGinnis E, Keen J, Muir D, Wilson L, Stubbs N, Dealey C, Brown S, Nelson EA, Nixon J, et al.
Journal of advanced nursing. Date of publication 2018 Feb 1;volume 74(2):407-424.
1. J Adv Nurs. 2018 Feb;74(2):407-424. doi: 10.1111/jan.13444. Epub 2017 Sep 28.
Clinical evaluation of a new pressure ulcer risk assessment instrument, the
Pressure Ulcer Risk Primary or Secondary Evaluation Tool (PURPOSE T).
Coleman S(1), Smith IL(1), McGinnis E(1)(2), Keen J(3), Muir D(1), Wilson
L(1)(4), Stubbs N(5), Dealey C(6), Brown S(1), Nelson EA(7), Nixon J(1).
Author information:
(1)Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research,
University of Leeds, Leeds, UK.
(2)Leeds Teaching Hospitals NHS Trust, Leeds, UK.
(3)Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
(4)Mid Yorkshire Hospital NHS Trust, Wakefield, UK.
(5)Wound Prevention and Management Service, Leeds Community Healthcare NHS
Trust, Leeds, UK.
(6)School of Health & Population Sciences, University of Birmingham, Birmingham,
UK.
(7)School of Healthcare, University of Leeds, Leeds, UK.
AIM: To test the psychometric properties and clinical usability of a new
Pressure Ulcer Risk Assessment Instrument including inter-rater and test-retest
reliability, convergent validity and data completeness.
BACKGROUND: Methodological and practical limitations associated with traditional
Pressure Ulcer Risk Assessment Instruments, prompted a programme to work to
develop a new instrument, as part of the National Institute for Health Research
funded, Pressure UlceR Programme Of reSEarch (RP-PG-0407-10056).
DESIGN: Observational field test.
METHOD: For this clinical evaluation 230 patients were purposefully sampled
across four broad levels of pressure ulcer risk with representation from four
secondary care and four community NHS Trusts in England. Blinded and
simultaneous paired (ward/community nurse and expert nurse) PURPOSE-T
assessments were undertaken. Follow-up retest was undertaken by the expert
nurse. Field notes of PURPOSE-T use were collected. Data were collected October
2012-January 2013.
RESULTS: The clinical evaluation demonstrated "very good" (kappa) inter-rater
and test-retest agreement for PURPOSE-T assessment decision overall. The
percentage agreement for "problem/no problem" was over 75% for the main risk
factors. Convergent validity demonstrated moderate to high associations with
other measures of similar constructs.
CONCLUSION: The PURPOSE-T evaluation facilitated the initial validation and
clinical usability of the instrument and demonstrated that PURPOSE-T is suitable
of use in clinical practice. Further study is needed to evaluate the impact of
using the instrument on care processes and outcomes.
© 2017 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons
Ltd.
DOI: 10.1111/jan.13444
PMCID: PMC5846883
PMID: 28833356 [Indexed for MEDLINE]
