Pressure Ulcers in Hospitalized Children: Prospective Observational Study and Italian Linguistic and Cultural Validation of the Glamorgan Pediatric Pressure Ulcer Risk Assessment Scale

Background: Pressure Ulcers (PU) in hospitals are a major problem, including in pediatric settings. Knowledge of the epidemiology and risk factors of PUs is important, as is the use of a specific tool for the assessment of PU risk, which would allow the identification of subjects at risk. No Pediatric PU Risk Assessment Scales are currently validated in Italian. The goals of this study were: to perform the linguistic and cultural validation of the Glamorgan Pediatric Pressure Ulcer Risk Assessment Scale (GS) in Italian, to estimate its predictive performance and to estimate the frequency of PUs of hospitalized children.

Methods: The study consists of two steps. First, linguistic and cultural validation of the GS in Italian. Second, evaluation of the Italian GS’s performance on 1500 hospitalized children and estimate of PU frequency in hospitalized children.

Results: The Italian version of the scale (GS-ita) has satisfactory validity (SCVI=0.93) and inter-rater reliability (Cohen’s kappa=0.95). The second step is ongoing. So far 1212 subjects have been recruited. Preliminary analysis shows a frequency of PUs in hospitalized children of 5.8 ‰ (CI 95% 2.5–11.4). Based on the subjects recruited so far, the sensitivity of the GS-ita is 100% (CI95% 59 to 100) and the specificity is 44.5% (CI95% 41.6 to 47.3) Conclusions: Based on preliminary data, the performance of GS-ita is similar to those of the original English version. The frequency of PUs estimated on the basis of preliminary data is consistent with previous studies. Italian speaking pediatric nurses have now a novel tool to evaluate the risk of PUs in children and, consequently, to better prevent the onset of PUs. The study will continue until 1500 patients are recruited.

Keywords: Pressure Ulcers, children, risk assessment scales, pediatric hospitals, risk management.