A new scale for assessing the risk of pressure ulcers in neonates

Pressure ulcers are an adverse event recognised in paediatric units and specifically in neonatal units. Within the research line on Pressure ulcers and chronic wounds, Pablo García-Molina, during his PhD supervised by Dr. Francisco P. García Fernández, a member of our group, adapted the Neonatal Skin Risk Assessment Scale to the Spanish context and tested its validity and reliability. The Journal of Nursing Management recently published the Spanish version of the scale, e-NSRAS. The intent of the Spanish Neonatal Skin Risk Assessment Scale is to identify hospitalised neonates requiring prevention measures and their specific risk factors, to provide useful diagnostic information to improve the neonatal skin care into Spanish speaking countries.

The research was performed in 10 neonatal units. Overall, we use an observational study design, but divided it in to three stages. In the first stage, the transcultural adaptation of the scale and its content validation was performed. For the second stage, the inter-rater / intra-rater agreement and construct validity were evaluated using a cross-sectional
design. Finally, in the third stage, a cohort study to analyse pressure ulcers’ incidence, diagnostic tests and the cut-off points of the scale was performed.

Through this rigorous validation process, the e-NSRAS could ensure the efficient and effective allocation of limited preventive resources, support clinical and management decisions, allow risk-adjusted cases in epidemiological studies, facilitate the development of risk assessment protocols and serve as evidence in litigation cases. All these features could facilitate developing best practice in nursing management and improve the quality and safety of neonatal care.

See the reference: Pablo García-Molina, Evelin Balaguer López, José Verdú, Andreu Nolasco, Francisco P. García Fernández. Cross-cultural adaptation, reliability and validity of the Spanish version of the Neonatal Skin Risk Assessment Scale. J Nurs Manag. 2018;1–13.

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