Category I Pressure Ulcers How Reliable Is Clinical Assessment?

INTRODUCTION: Pressure ulcer prevention is an indicator of quality of care. Reliable identification of Category I pressure ulcers is essential in prevalence studies and to prevent further tissue damage. PURPOSE: The primary purpose of this study was to establish interrater reliability between blanching and nonblanching erythema assessed by 2 independent assessors. The secondary purpose was to investigate potential correlations between risk factors and pressure ulcers. METHOD: Ninety-seven patients 65 years or older with hip fractures were consecutively recruited for this prospective, comparative observation study. Seventy-eight patients completed the study. The sacral area of each patient was visually assessed and a finger-press test was administered to each patient by 2 independent assessors. Kappa statistics were used for analysis. FINDINGS: finger-press tests and visual observation alone were not reliable methods to discriminate between blanching and nonblanching erythema. Forty-seven percent of the patients had a risk score 20 or fewer (high risk for pressure ulcers). Forty-four patients (56%) had pressure ulcers at discharge.