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Abstract：
BACKGROUND: Patients who are intubated in the ICU are at risk of developing pressure injuries to the mouth and lips from endotracheal tubes. Clear documentation is important for pressure wound care; however, no validated instruments currently exist for the staging of pressure injuries to the oral mucosa. Instruments designed for the assessment of pressure injuries to other bodily regions are anatomically unsuited to the lips and mouth.
OBJECTIVE: This study aimed to develop and then assess the reliability of a novel scale for the assessment of pressure injuries to the mouth and oral mucosa.
METHODS: The Reaper Oral Mucosa Pressure Injury Scale (ROMPIS) was developed in consultation with ICU nurses, clinical nurse educators, Intensivists, and experts in pressure wound management. ICU nurses and portfolio-holders in pressure wound care from Peninsula Health (Victoria, Australia) were invited to use the ROMPIS to stage 19 de-identified clinical photographs of oral pressure injuries via secure online survey. Inter-rater reliability (IRR) was calculated using Krippendorff\'s alpha (α).
RESULTS: Among ICU nurses (n=52), IRR of the ROMPIS was α=0.307; improving to α=0.463 when considering only responses where injuries were deemed to be stageable using the ROMPIS (i.e. excluding responses where respondents considered an injury to be unstageable). Among a cohort of experts in pressure wound care (n=8), IRR was α=0.306; or α=0.443 excluding responses indicating that wounds were unstageable.
CONCLUSIONS: An instrument for the assessment and monitoring of pressure injuries to the mouth and lips has practical implications for patient care. This preliminary study indicates that the ROMPIS instrument has potential to be used clinically for this purpose; however, the performance of this scale may be somewhat reliant on the confidence or experience of the ICU nurse utilising it. Further validation is required.
OBJECTIVE: This study aimed to develop and then assess the reliability of a novel scale for the assessment of pressure injuries to the mouth and oral mucosa.
METHODS: The Reaper Oral Mucosa Pressure Injury Scale (ROMPIS) was developed in consultation with ICU nurses, clinical nurse educators, Intensivists, and experts in pressure wound management. ICU nurses and portfolio-holders in pressure wound care from Peninsula Health (Victoria, Australia) were invited to use the ROMPIS to stage 19 de-identified clinical photographs of oral pressure injuries via secure online survey. Inter-rater reliability (IRR) was calculated using Krippendorff\'s alpha (α).
RESULTS: Among ICU nurses (n=52), IRR of the ROMPIS was α=0.307; improving to α=0.463 when considering only responses where injuries were deemed to be stageable using the ROMPIS (i.e. excluding responses where respondents considered an injury to be unstageable). Among a cohort of experts in pressure wound care (n=8), IRR was α=0.306; or α=0.443 excluding responses indicating that wounds were unstageable.
CONCLUSIONS: An instrument for the assessment and monitoring of pressure injuries to the mouth and lips has practical implications for patient care. This preliminary study indicates that the ROMPIS instrument has potential to be used clinically for this purpose; however, the performance of this scale may be somewhat reliant on the confidence or experience of the ICU nurse utilising it. Further validation is required.
摘要：
背景：在ICU中插管的患者有可能因气管内导管对口腔和嘴唇造成压力损伤。清晰的文档对于压力伤口护理很重要；但是，目前尚无经过验证的工具来分期口腔粘膜压力性损伤。设计用于评估对其他身体区域的压力伤害的仪器在解剖学上不适合嘴唇和嘴。
目的：本研究旨在开发一种用于评估口腔和口腔粘膜压力性损伤的新型量表，然后评估其可靠性。
方法：收割者口腔粘膜压力损伤量表（ROMPIS）是与ICU护士协商后制定的，临床护士教育者，密集主义者，和压力伤口管理专家。半岛健康医院压力伤口护理的ICU护士和投资组合持有人(维多利亚，澳大利亚）被邀请使用ROMPIS通过安全的在线调查对口腔压力损伤的第19阶段进行去识别的临床照片。使用Krippendorffα(α)计算评估者间可靠性(IRR)。
结果：在ICU护士（n=52）中，ROMPIS的IRR为α=0.307；当仅考虑使用ROMPIS认为伤害是可分阶段的反应时，提高到α=0.463（即不包括受访者认为伤害是不可分阶段的反应）。在一组压力伤口护理专家中（n=8），IRR为α=0.306；或α=0.443，不包括表明伤口不可停滞的反应。
结论：一种评估和监测口腔和嘴唇压力损伤的工具对患者护理具有实际意义。这项初步研究表明，ROMPIS仪器有可能在临床上用于此目的；然而，该量表的性能可能在一定程度上取决于ICU护士使用该量表的信心或经验.需要进一步验证。
目的：本研究旨在开发一种用于评估口腔和口腔粘膜压力性损伤的新型量表，然后评估其可靠性。
方法：收割者口腔粘膜压力损伤量表（ROMPIS）是与ICU护士协商后制定的，临床护士教育者，密集主义者，和压力伤口管理专家。半岛健康医院压力伤口护理的ICU护士和投资组合持有人(维多利亚，澳大利亚）被邀请使用ROMPIS通过安全的在线调查对口腔压力损伤的第19阶段进行去识别的临床照片。使用Krippendorffα(α)计算评估者间可靠性(IRR)。
结果：在ICU护士（n=52）中，ROMPIS的IRR为α=0.307；当仅考虑使用ROMPIS认为伤害是可分阶段的反应时，提高到α=0.463（即不包括受访者认为伤害是不可分阶段的反应）。在一组压力伤口护理专家中（n=8），IRR为α=0.306；或α=0.443，不包括表明伤口不可停滞的反应。
结论：一种评估和监测口腔和嘴唇压力损伤的工具对患者护理具有实际意义。这项初步研究表明，ROMPIS仪器有可能在临床上用于此目的；然而，该量表的性能可能在一定程度上取决于ICU护士使用该量表的信心或经验.需要进一步验证。
