Objective: The purpose was to provide support for validity and reliability of the spinal cord impairment pressure ulcer monitoring tool (SCI-PUMT) to assess pressure ulcer (PrU) healing. Design: Expert panels developed a 30-item pool, including new items and items from two established PrU healing tools, to represent potential variables for monitoring PrU healing. Subjects were prospectively assessed weekly for each variable over a 12-week period. Setting: Data collection was conducted on a cohort of inpatients and outpatients in one Spinal Cord Injury/ Disorders Center in the Veterans' Health Administration. Subjects: A convenience sample of Veterans (n = 66) with spinal cord impairment (SCI) was recruited. Eligible subjects had at least one PrU (n = 167) and a history of SCI for longer than 1 year. Interventions: Not applicable. Outcome Measure: A change in PrU volume was calculated using VeV Measurement Documentation software and a digital imaging camera. Results: Content validity was established for a pool of items designed to gauge PrU healing. Exploratory factor analysis (construct validity) identified a parsimonious set of seven items for inclusion in the SCI-PUMT to assess PrU healing. The SCI-PUMT was found to explain 59% of the variance of the volume across the study. Inter-rater reliability was 0.79 and intra-rater reliability ranged from 0.81 to 0.99 among research assistants. Similar levels of reliability were subsequently established among registered nurses, who used the SCI-PUMT in the clinical setting. Conclusions: The final version of the SCI-PUMT was determined to be valid, reliable, and sensitive in detecting PrU healing over time in Veterans with SCI. The objective of this measurement study was to evaluate the psychometric properties of a new clinical assessment tool, the SCI Pressure Ulcer Monitoring Tool (SCI-PUMT). Research questions were: (1) Is there evidence to support the validity of the SCI-PUMT as a measure of PrU healing? (2) Is there evidence to support the reliability of the SCI-PUMT as a measure of PrU healing in the clinical setting? (3) How does the prediction of PrU healing by the SCI-PUMT compare with that of currently used clinical tools over time?Evaluating PrU healing in the SCI population has been challenging, making the quantitative effectiveness of treatment strategies that result in PrU changes over time difficult to measure. Practice to monitor PrU healing among VHA SCI centers ranged from using tools with established reliability and validity for non-SCI populations, using locally developed tools lacking psychometric testing, and using non-PrU wound assessments. Although determining the success of topical treatments, support surfaces, nutrition, and other interventions are based on the trajectory of PrU healing, methods to measure this have been inconsistent. formerly known as the Pressure Sore Status Tool (PSST). 9 The PUSH and BWAT provided a starting point for the development of SCI-PUMT and will be briefly discussed.
Pressure Ulcer Scale for Healing (PUSH)The PUSH,...