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BACKGROUND: Medical device-related pressure injury (MDRPI) is a major patient safety issue in intensive care units (ICUs), where invasive devices, impaired consciousness and fragile skin tolerance increase risk. Generic risk scales such as Braden and Norton do not account for device-skin interface mechanisms, leading to the underestimation of MDRPI risk. No ICU-specific validated MDRPI risk assessment instrument has been reported in Indonesia. AIM: To develop and preliminarily validate a concise, ICU-specific, mechanism-based risk assessment instrument for MDRPI. STUDY DESIGN: Methodological instrument development and validation study guided by the COSMIN framework, comprising three phases: literature review and item generation, three-round Delphi consensus with wound care experts, and pilot testing among ICU patients. RESULTS: Delphi consensus reduced 31 candidate items to six domains: nutrition, moisture/microclimate, sensory perception, friction/shear, external device and consciousness. Content validity was excellent (I-CVI = 1.00 S-CVI/Ave = 1.00). Internal consistency was acceptable (Cronbach's α = 0.81-0.85). Receiver operating characteristic analysis demonstrated excellent discriminative performance (AUC = 0.96), with an optimal cut-off score of ≥ 14 for identifying patients at high risk of MDRPI. CONCLUSIONS: The 6-item ICU-specific MDRPI risk assessment instrument demonstrated robust preliminary validity and reliability. It addresses key limitations of generic scales and provides a feasible framework for MDRPI risk stratification in critical care settings. RELEVANCE TO CLINICAL PRACTICE: The instrument supports early identification of high-risk ICU patients, facilitates targeted preventive interventions and is suitable for integration into routine bedside assessment and electronic health record systems.
Ali et al. (Thu,) studied this question.