The high incidence of pressure ulcer development in patients in the perioperative setting indicates the need for improved risk assessment and the use of preventive measures. A clinical nurse specialist used Dever's Epidemiological Model as the theoretical framework to develop a perioperative pressure ulcer risk-assessment scale. The risk factors for the scale were based on findings from a review of the literature. The scale, along with a demographic questionnaire and an evaluation form, was distributed to 12 nurses and three anesthesiologists to obtain expert opinion to further the design of the scale. Twelve participants returned the forms. Only four of the participants had previous experience with a pressure ulcer risk-assessment scale. The results indicated that diabetes should be included as a risk factor category and that preexisting skin ulcerations, breakdowns, and conditions should be addressed within the scale. The participants unanimously agreed that moisture is an important factor to assess. Validation of each risk factor is essential to improve the reliability of the scale before its implementation.

Background and Purpose:The Munro Pressure Injury Risk Assessment Scale for Perioperative Patients (Munro Scale) is the first three-phase risk instrument designed specifically for perioperative patients. The purpose of this study was to establish validity and reliability evidence for the Munro Scale. This study also had a goal to reduce the data into more manageable constructs with fewer items.Methods:Exploratory and confirmatory factor analyses were used to test the hypothesized model for risk assessment using the Munro Scale to identify latent variables. A retrospective review of charts from 630 risk assessments was analyzed from two community acute care hospital settings.Results:The model explained 95% of the variance in the cumulative final risk level, R2= .95,F(20, 588) = 501.88,p< .001. Six latent variables emerged in the model with a cumulative contribution rate of 56% of the variance. Similar results were obtained in studies with Chinese and Turkish translations of the Munro Scale.Conclusions:The validity and reliability evidence obtained in this study supports the implementation of the Munro Scale for clinical practice in the perioperative setting.

Background and Purpose:Patients undergoing surgery are at risk of pressure injury development and should be assessed to ensure measures are taken for prevention. The study’s purpose was to examine the causal relationships and reliability of the Munro Pressure Injury Risk Assessment Scale for Perioperative Patients (Munro Scale). The Munro Scale is the first dynamic risk scale available for this patient population in the acute clinical setting.Methods:This study was a retrospective review to explore the relationships of the variables in the Munro Scale, identify the strongest predictors, and measure the reliability of previously collected data from two northeastern community hospitals. A total of 630 risk assessments were analyzed to obtain regression, correlation, and reliability evidence for the Munro Scale.Results:The correlation analysis among the 15 risk variables and combined comorbidities revealed commonalities among the variables and significant relationships to the final postoperative injury score. The model as a whole is significant to predict the final level of risk. Cronbach’sαrevealed a lower than anticipated reliability when compared to the Chinese, Turkish, and Brazilian versions of the Munro Scale.Conclusions:There are significant relationships among the variables, and the scale is acceptable for use in the acute perioperative practice setting. This study has both clinical and statistical significance.