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Development of a valid pressure ulcer surveillance program First Author: Laura Teague, RN, MN, ACNP Authors: Carol Banez, RN,MAN; Claudia Ganson, RN, BScN, ET; Lianne Jeffs, RN, MSc; Jianli Li, PhD; Rola Moghabghab, RN, MN, ACNP, GNC(C); Karen Polansky, RN, MScN, CNS; Louanne Rich-vanderBij, RN, MSc, CWCN, COCN; Pamela Savage, RN, MAEd, CON(C); & Sandra Tully, R Surveillance of pressure ulcer prevalence and prevention practices reflects patient safety and quality of care1. Accurate surveillance is required to identify aspects of care that are most amenable to both measurement and improvement2. Variation in data collection methods makes interpretation and benchmarking problematic3. Moreover, validity and reliability of existing industry sponsored data collection programs have not been reported. The purpose of this project was to develop and validate a pressure ulcer prevalence/surveillance program that includes a data collection tool, user manual, education module to standardize data collection and finally a robust statistical program. Since 2001, a Canadian tri-hospital consortium has used an iterative process to establish validity, utility, feasibility and relevance of this evidence-based program. Methods employed to validate the program include a literature review, tool development, pilot testing of prototypes annually for three years (n=1045) and focus groups with end users (data collection teams). Finally, an expert content panel was convened to further establish content validity through a modified Delphi approach. Statistical methods employed included univariate and multivariate methods to derive a model that fit the data elements and identified factors significantly associated with pressure ulcers, employing a stepwise selection method. Performance of the model was evaluated using area under the receiver operating characteristic curve (ROC) and Hosmer-Lemeshow goodness-of-fit test. Odds ratios (OR) were calculated for the factors significantly associated with pressure ulcers. This validated, evidence-based surveillance program can allow acute care facilities to accurately monitor and set benchmarks for quality improvement in the area of pressure ulcer prevention. |
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