背景:需要一种基于证据和共识的工具来对中心静脉接入装置相关的皮肤损伤进行分类。
目的:本研究的目的是设计和评估中心静脉接入装置相关的皮肤损伤分类工具。
方法:两阶段改进的德尔菲研究。
方法:这项两阶段研究包括文献综述,其次是分类工具的开发和验证,由中心静脉接入装置和伤口管理领域的专家(第一阶段)。由相同的专家小组使用一系列相关皮肤损伤的38张临床照片对仪器进行测试(阶段2)。专家小组由注册护士组成,他们是临床研究人员(n=4)和临床专家(n=3),平均具有24年的护理和研究经验以及11年的伤口管理经验。使用了评估初步内容效度和评估者间信度的措施。
结果:该仪器包括五个总体病因分类,包括接触性皮炎,机械损伤,感染,压力损伤和复杂的临床表现,与14个相关的子类别诊断(例如,过敏性皮炎,皮肤撕裂和局部感染),定义和体征和症状。初步量表内容效度和项目内容效度(I-CVI=1)达到了很高的一致性。病因的评估者间可靠性很高。个体定义,体征和症状的总体评估者之间的可靠性具有极好的一致性。
结论:该分类工具的开发和初步验证为指导中心静脉接入装置相关皮肤损伤的分类和评估提供了一种通用语言。
结论:全面且经过验证的分类工具将通过为医疗保健提供者建立通用语言来促进对中心静脉接入装置相关皮肤损伤的准确识别。该工具的可用性可以减少临床不确定性,误诊和管理不善的可能性。因此,它将在指导临床决策方面发挥关键作用,最终提高治疗质量并改善患者预后。
■遵守《开展和报告德尔菲研究指南》(CREDES)。
■没有患者或公众捐款。
BACKGROUND: An evidence and consensus-based instrument is needed to classify central venous access device-associated skin impairments.
OBJECTIVE: The aim of this study was to design and evaluate the central venous access device-associated skin impairment classification tool.
METHODS: A two-phase modified Delphi study.
METHODS: This two-phase study consisted of a literature review, followed by the development and validation of a classification instrument, by experts in the fields of central venous access devices and wound management (Phase 1). The instrument was tested (Phase 2) using 38 clinical photographs of a range of relevant skin impairments by the same expert panel. The expert panel consisted of registered nurses who were clinical researchers (n = 4) and clinical experts (n = 3) with an average of 24 years of
nursing and research experience and 11 years of experience in wound management. Measures to assess preliminary content validity and inter-rater reliability were used.
RESULTS: The instrument consists of five overarching aetiological classifications, including contact dermatitis, mechanical injury, infection, pressure injury and complex clinical presentation, with 14 associated subcategory diagnoses (e.g., allergic dermatitis, skin tear and local infection), with definitions and signs and symptoms. High agreement was achieved for preliminary scale content validity and item content validity (I-CVI = 1). Inter-rater reliability of aetiologies was high. The overall inter-rater reliability of individual definitions and signs and symptoms had excellent agreement.
CONCLUSIONS: The development and preliminary validation of this classification tool provide a common language to guide the classification and assessment of central venous access device-associated skin impairment.
CONCLUSIONS: The comprehensive and validated classification tool will promote accurate identification of central venous access device-associated skin impairment by establishing a common language for healthcare providers. The availability of this tool can reduce clinical uncertainty, instances of misdiagnosis and the potential for mismanagement. Consequently, it will play a pivotal role in guiding clinical decision-making, ultimately enhancing the quality of treatment and improving patient outcomes.
UNASSIGNED: The Guidance on Conducting and Reporting Delphi Studies (CREDES) was adhered to.
UNASSIGNED: No patient or public contribution.