The development of the Glamorgan paediatric pressure ulcer risk assessment scale

Abstract

Using patient data from children and young people in the development of risk assessment tools for this age group may be preferable to modifying existing adult tools.

Do pressure ulcer risk assessment scales improve clinical practice?

“…Second, the specific importance of single risk factors is not adequately taken into account as long as all items are equally weighted 23. PU risk scales considering weights in their scores are available, but most often these weights are arbitrary, eg, in the Waterlow9 or in the Glamorgan scale 24. Today, there are only a few PU scales containing weights that were developed on a more rational basis, eg, the mul-tifactorial approach taken by Nonnemacher et al19…”

Pressure Ulcers in Neonates and Children

“…30,31,33 The Glamorgan Scale has 11 statistically significant pediatric pressure ulcer risk factors: 30,31,33 & inability to move without great difficulty or deterioration in condition or having prolonged surgery & inability to change position without assistance/inability to control body movement & some mobility, but reduced for age & equipment/objects/hard surface pressing or rubbing on skin & significant anemia (hemoglobin < 9 g/dL) & persistent pyrexia (temperature > 37.5C for more than 12 hours) & poor peripheral perfusion (cold extremities/capillary refill > 2 seconds/cool mottled skin) & inadequate nutrition (unable to take/not absorbing oral or enteral feeds and not supplemented with hyperalimentation) & low serum albumin level (<3.5 g/dL) 30,31,33 The Glamorgan Scale has 11 statistically significant pediatric pressure ulcer risk factors: 30,31,33 & inability to move without great difficulty or deterioration in condition or having prolonged surgery & inability to change position without assistance/inability to control body movement & some mobility, but reduced for age & equipment/objects/hard surface pressing or rubbing on skin & significant anemia (hemoglobin < 9 g/dL) & persistent pyrexia (temperature > 37.5C for more than 12 hours) & poor peripheral perfusion (cold extremities/capillary refill > 2 seconds/cool mottled skin) & inadequate nutrition (unable to take/not absorbing oral or enteral feeds and not supplemented with hyperalimentation) & low serum albumin level (<3.5 g/dL)…”

“…30,31 An international, multicenter study examining the interrater reliability of the Glamorgan Scale is currently in progress. 30,31 An international, multicenter study examining the interrater reliability of the Glamorgan Scale is currently in progress.…”

Cross-cultural adaptation, reliability and validity of the Spanish version of the Neonatal Skin Risk Assessment Scale

“…Some authors said that these current neonatal scales present major limitations (García‐Fernández et al., ; Kottner et al., ). Neonatal scales include: the Neonatal Skin Condition Scale (Lund & Osborne, ), which is not specific for PU risk assessment and its study validation did not assess the PU, rather only skin condition and the prevalence of skin infection; the Seton scale (Vance, Demel, Kirksey, Moynihan, & Hollis, ), which remains under preparation and cannot be used because it is not fully designed and validated; the Neonatal/Infant Braden Q scale (Ashworth & Briggs, ), which is currently under validation (de Lima, de Brito, Souza, Salome, & Ferreira, ), a free adaptation of the Braden Q scale with the addition of the subscale “General Physical Condition” from the Neonatal Skin Risk Assessment Scale (NSRAS); the Glamorgan scale (Willock, Baharestani, & Anthony, ), designed for children from birth to 14 years old, evaluated in a retrospective study with inappropriate inter‐rater reliability measures, only provide information about the degree and direction of association; and the NSRAS (Huffines & Logsdon, ), based on the adult Braden scale, with a convenience sampling, small sample size and the missing replications. None of the described scales has been validated properly.…”