Abstract: Criteria for Determining an Unavoidable Pressure Ulcer: Pressure Ulcer Inventory Tool (45th Annual Conference (June 22-26, 2013 ))

Terrie Beeson, MSN, RN, CCRN, ACNS-BC¹, Joyce Pittman, PhD, FNP-BC, CWOCN², Jill Dillon, MSN, RN, CCRN, ACNS-BC¹, Judith Mosier, RN, MS, BSN, CWOCN³, Charity Hampton, BSN, RN, CCRN⁴, Denise Kerley, BSN, RN, CNRN⁴, Ellen Gumiela, BSN, RN⁴ and Jessica Tucker, BSN, RN⁴, (1)Indiana University Health, Clinical Nurse Specialist, Indianapolis, IN, (2)Indiana University Health- Methodist Hospital, Wound/Ostomy Team Leader, Indianapolis, IN, (3)Indiana University Health (Methodist), Certified Wound, Ostomy, Continence Nurse, Indianapolis, IN, (4)Indiana University Health, RN, Indianapolis, IN

Title: Criteria for Determining an Unavoidable Pressure Ulcer: Pressure Ulcer Inventory Tool

Introduction/Background:

Despite numerous advancements and prevention methods, pressure ulcer prevalence and incidence has continued to climb¹. Raising the question, are all pressure ulcers preventable? CMS², NPUAP³and the WOCN⁴ Society have developed statements defining an avoidable and unavoidable pressure ulcer, not specific to the acute care setting.

Purpose:

1) Develop a definition for hospital-acquired avoidable and unavoidable pressure ulcers, 2) develop an instrument Pressure Ulcer Inventory (PUI) to identify hospital-acquired avoidable and unavoidable pressure ulcers, and; 3) examine the content validity of the PUI.

Methods:

Design- An evidenced based definition and instrument were developed to identify whether a hospital acquired pressure ulcer was avoidable versus unavoidable. Utilizing the instrument guidelines established by DeVellis⁵the PUI was developed.

Analyses:

Content validity was examined using content validity indices. Continuous measures were summarized using mean and standard deviation.

Findings:

Ten experts were invited to participate in the review of the Pressure Ulcer Inventory for content validity for relevance of each item. Excellent content validity of the instrument was demonstrated with an overall total CVI of 0.99. Each item was also rated for clarity, comprehensiveness, and appropriateness, demonstrating acceptable validity scores.

Conclusion/Implication:

This study’s findings provide an evidence based definition for identifying avoidable and unavoidable pressure ulcers in the acute care setting. Recommendations from expert reviewers were taken into account and appropriate revisions were implemented. Resulting in a valid instrument used to determine whether a hospital acquired pressure ulcer is avoidable versus unavoidable. In progress are analyses to determine reliability of the instrument and pilot the Pressure Ulcer Inventory in a retrospective review of 30 patients’ medical records.

1760 Criteria for Determining an Unavoidable Pressure Ulcer: Pressure Ulcer Inventory Tool