Abstract

RODRIGUEZ TORRES, María del Carmen  and  SOLDEVILLA AGREDA, J. Javier. Clinical judgement or assessment scales to identify patients at risk of developing pressure ulcers?. Gerokomos [online]. 2007, vol.18, n.1, pp.48-51. ISSN 1134-928X.

Clinical practice question: In the patients at risk of developing pressure ulcers, can the use of a validated risk assessment scale predict the risk more efficiently than the clinical judgement? Original paper: Pancorbo-Hidalgo PL, García-Fernández FP, López-Medina IM, Álvarez-Nieto C. Risk assessment scales for pressure ulcer prevention: to systematic review. Journal of Advanced Nursing 2006; 54 (1): 94-110. Summary of the research: The present study is a systematic review aiming to determine the clinical effectiveness of the risk assessment scales (RAS) for pressure ulcers (PU), their validity and their capacity to measure the risk and to compare it with the nurses' clinical judgement. The scale of Braden offers the best predicting score [OR 4.08 (CI 95%= 2.56-6.48)]. The clinical judgement is not a good predictor of the PU risk [OR 1.69 (CI 95%= 0.76-3.75)]. Critical comment: The authors have performed an exhaustive search and followed a rigorous method to assess the papers; therefore, the study has internal validity. This revision included a wide number or original papers, representing research in different countries and settings, and the outcomes have been analyzed together by metaanalysis. All these elements confer enough external validity to the study, by which reason the results we can extrapolated. This study is relevant in several aspects. First of all, it demonstrates that when a validated RAS is used as criterion to allocate preventive resources, there is an increase in its effectiveness. This paper also shows that there are objective differences among scales. Braden scale offers the best performance indicators. Clinical judgement has not enough PU risk predictive value.

Keywords : Critical review; systematic review; clinical judgement; risk assessment scales.

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