Evaluation of the internal and external responsiveness of the Pressure Ulcer Scale for Healing (PUSH) tool for assessing acute and chronic wounds

Abstract

Aim To examine the internal and external responsiveness of the Pressure Ulcer Scale for Healing (PUSH) tool for assessing the healing progress in acute and chronic wounds. Background It is important to establish the responsiveness of instruments used in conducting wound care assessments to ensure that they are able to capture changes in wound healing accurately over time. Design Prospective longitudinal observational study. Method The key study instrument was the PUSH tool. Internal responsiveness was assessed using paired t‐testing and effect size statistics. External responsiveness was assessed using multiple linear regression. All new patients with at least one eligible acute or chronic wound, enrolled in the Nurse and Allied Health Clinic‐Wound Care programme between 1 December 2012 – 31 March 2013 were included for analysis (N = 541). Results Overall, the PUSH tool was able to detect statistically significant changes in wound healing between baseline and discharge. The effect size statistics were large. The internal responsiveness of the PUSH tool was confirmed in patients with a variety of different wound types including venous ulcers, pressure ulcers, neuropathic ulcers, burns and scalds, skin tears, surgical wounds and traumatic wounds. After controlling for age, gender and wound type, subjects in the ‘wound improved but not healed’ group had a smaller change in PUSH scores than those in the ‘wound healed’ group. Subjects in the ‘wound static or worsened’ group had the smallest change in PUSH scores. The external responsiveness was confirmed. Conclusion The internal and external responsiveness of the PUSH tool confirmed that it can be used to track the healing progress of both acute and chronic wounds.

Identifying risk factors associated with infection in patients with chronic leg ulcers

“…A decrease in the total PUSH score can be seen as an indicator for positive wound healing . The PUSH tool has been validated for use with monitoring healing and severity of chronic wounds …”

“…24 The PUSH tool has been validated for use with monitoring healing and severity of chronic wounds. 30 A clinical diagnosis of infection was recorded in all the contributing studies, and 1 study documented a detailed range of clinical signs of infection by the clinician who was in charge of care.…”

Review of the Current Management of Pressure Ulcers

“…(Table 3). 30 Another commonly used scale is the Bates-Jensen wound assessment tool which scores wounds based on size, depth, wound edges, tissue undermining, type and amount of necrotic tissue, type and amount of exudate, skin color, presence of edema, induration, granulation, and epithelialization. 31 Other similar tools such as the pressure sore status tool and Sessing scale are also of use.…”

Prevalência E Caracterização De Feridas Crônicas Em Idosos Assistidos Na Atenção Básica

“…Ocorre em ritmos e velocidades diferentes nas várias regiões do mundo, sendo que os aspectos que interferem na expansão da população com essa faixa etária são as mudanças nas condições de vida e os avanços da medicina no combate a enfermidades, os quais reduzem as mortalidades precoces, como também promovem a longevidade. Neste sentido, com o envelhecimento da população, consequentemente há aumento global de doenças crônicas, sendo previsível também elevação concomitante no número de pessoas com lesões secundárias à patologia de base (1) .…”