Pressure ulcer risk screening in hospitals and nursing homes with a general nursing assessment tool: evaluation of the care dependency scale
Article first published online: 18 FEB 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd
Journal of Evaluation in Clinical Practice
Volume 14, Issue 6, pages 1018–1025, December 2008
How to Cite
Mertens, E. I., Halfens, R. J. G., Dietz, E., Scheufele, R. and Dassen, T. (2008), Pressure ulcer risk screening in hospitals and nursing homes with a general nursing assessment tool: evaluation of the care dependency scale. Journal of Evaluation in Clinical Practice, 14: 1018–1025. doi: 10.1111/j.1365-2753.2007.00935.x
- Issue published online: 6 NOV 2008
- Article first published online: 18 FEB 2008
- Accepted for publication: 24 July 2007
- care dependency;
- nursing homes;
- pressure ulcer risk;
- pressure ulcer;
- risk assessment
Rationale In view of an increasing necessity for systematic assessments, nursing practice would benefit from a simplification of assessment procedures. These assessments should be scientifically based.
Aims To evaluate the possibility of assessing pressure ulcer risk as well as care dependency simultaneously with a standardized instrument for nursing homes and hospitals.
Methods Care dependency was measured with the Care Dependency Scale (CDS). The quantitative analyses were accomplished with data from a cross-sectional study that was performed in 2005 in 39 German nursing homes and 37 hospitals with a total of more than 10 000 participants. The scale's construct validity was calculated with Pearson's r, and predictive validity was evaluated by computing sensitivity and specificity values and the area under the curve (AUC). Item-level analyses included calculations of odds ratios, relative risks and logistic regression analyses.
Results Construct validity of the CDS was r = 0.79 (P < 0.01) in nursing homes and r = 0.89 (P < 0.01) in hospitals. AUC was 0.80 in hospitals and 0.65 in nursing homes. Analyses on item level identified ‘mobility’ as a key item in both settings and additional differing key items for nursing homes and hospitals.
Conclusions The CDS is a well-functioning tool for pressure ulcer risk detection in hospitals. For this purpose, the most appropriate cut-off point is 69 while special regard is given to the items ‘continence’, ‘mobility’ and ‘hygiene’. In nursing homes the usefulness of the CDS for pressure ulcer risk detection is limited. Here, the most appropriate cut-off point is 41 and attention is given to the items ‘mobility’, ‘getting (un)dressed’, ‘hygiene’ and ‘avoidance of danger’.