The Development of a New Pressure Ulcer Risk Assessment Instrument

Introduction: 
This presentation will highlight the risk assessment work package of the NIHR PURPOSE Programme (Pressure Ulcer Programme of Research). It will describe the development a new evidence-based Risk Assessment Instrument for pressure ulcer (PU) prevention/management, PURPOSE-T and future work building on this programme.


Methods:
PURPOSE-T development comprised 5 phases: 
  1. Systematic review of PU risk factors [1].
  2. Consensus study to agree the risk factors, assessment items and structure of PURPOSE T [2].
  3. A new PU conceptual framework [3].
  4. Design and pre-testing of the draft PURPOSE-T to assess and improve the acceptability, usability and confirm content validity [4].
  5. Clinical evaluation in acute/community settings to assess reliability, validity, data completeness and clinical usability [5].
Results: 
PURPOSE-T incorporates a screening stage; a full assessment stage; use of colour to support decision making; and decision pathways making a clear distinction between patients with an existing PU(s) who require secondary prevention and treatment and those at risk who require primary prevention.

Discussions: 
PURPOSE-T has since been implemented in acute and community settings. Further evaluation is planned to assess its impact on processes of care and clinical outcomes.

References: 
1) Systematic review, IJNS, Coleman et al 2013
2) Consensus study, JAN, Coleman et al 2014a
3) Conceptual framework, JAN, Coleman et al 2014b
4) Pre-test, BMC Research Methods, in press
5) PURPOSE Monograph, Nixon et al, 2015

Acknowledgement
This presentation presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (RP-PG-0407-10056). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.


This lecture is Presented by Dr Susanne B Coleman

NIHR Post-Doc Research Fellow
Leeds Institute of Clinical Trials Research
University of Leeds
Leeds
LS2 9JT
Email: medscole@leeds.ac.uk