Pressure injury risk assessment in intensive care: comparison of inter-rater reliability of the COMHON (Conscious level, Mobility, Haemodynamics, Oxygenation, Nutrition) Index with three scales

Journal article


Fulbrook, Paul and Anderson, Alissa. (2016) Pressure injury risk assessment in intensive care: comparison of inter-rater reliability of the COMHON (Conscious level, Mobility, Haemodynamics, Oxygenation, Nutrition) Index with three scales. Journal of Advanced Nursing (online version). 73(3), pp. 680 - 692. https://doi.org/10.1111/jan.12825
AuthorsFulbrook, Paul and Anderson, Alissa
Abstract

Aim To test the psychometric properties of the COMHON (Conscious level, Mobility, Haemodynamics, Oxygenation, Nutrition) Index. Background Pressure injury risk assessment is a crucial aspect in determining the relative risk of patients and the need for preventative intervention. In the intensive care setting there are few risk assessment scales that have been developed specifically for critically ill patients. Design Instrument development. Methods A convenience sample of 26 intensive care patients was used. Data were collected in December 2012. Five intensive care nurses scored each patient with all four scales. Intraclass correlation coefficients and standard errors of measurement were used to assess inter-rater reliability and agreement of the sum, risk category and item scores. Convergent validity of the COMHON Index was investigated by examining correlations between the sum scores and similar constructs of the scales. Results Inter-rater reliability of the COMHON Index was higher than the other scales and strong correlations were found between it and the Braden and Norton scales but not the Waterlow score. Two items common to all scales (mobility; neurological status) demonstrated significant correlations between the COMHON, Braden and Norton scales but not the Waterlow score. One item (nutrition) was significantly correlated between the COMHON and Braden scales. Conclusion Inter-rater reliability and agreement of the COMHON Index were the highest of the four scales, with the Norton and Braden performing similarly and the Waterlow score the least well. The strong and significant associations between the Braden, COMHON and Norton scales suggest they are measuring similar constructs.

Year2016
JournalJournal of Advanced Nursing (online version)
Journal citation73 (3), pp. 680 - 692
ISSN0309-2402
Digital Object Identifier (DOI)https://doi.org/10.1111/jan.12825
Page range680 - 692
Research GroupSchool of Nursing, Midwifery and Paramedicine
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Fulbrook, Paul, Latour, Jos and Albarran, John. (2007) Paediatric critical care nurses' attitudes and experiences of parental presence during cardiopulmonary resuscitation: A European survey. International Journal of Nursing Studies. 44(7), pp. 1238 - 1249. https://doi.org/10.1016/j.ijnurstu.2006.05.006
Critical care nursing organizations and activities - a second worldwide review: Original article
Willia, Ged, Chaboyer, Wendy, Alberto, Laura, Thorsteinsdottir, Rosa, Schmollgruber, Shelley, Fulbrook, Paul, Chan, Dominic and Bost, Nerolie. (2007) Critical care nursing organizations and activities - a second worldwide review: Original article. International Nursing Review. 54(2), pp. 151 - 159. https://doi.org/10.1111/j.1466-7657.2007.00543.x
A European survey of enteral nutrition practices and procedures in adult intensive care units
Fulbrook, Paul, Bongers, Anke and Albarran, John. (2007) A European survey of enteral nutrition practices and procedures in adult intensive care units. Journal of Clinical Nursing. 16(11), pp. 2132 - 2141. https://doi.org/10.1111/j.1365-2702.2006.01841.x
The presence of family members during cardiopulmonary resuscitation: European federation of critical care nursing associations, European society of paediatric and neonatal intensive care and European society of cardiology council on cardiovascular
Fulbrook, Paul, Latour, Jos, Albarran, John, de Graaf, Wouter, Lynch, Fiona, Devictor, Denis and Norekval, Tone. (2007) The presence of family members during cardiopulmonary resuscitation: European federation of critical care nursing associations, European society of paediatric and neonatal intensive care and European society of cardiology council on cardiovascular. European Journal of Cardiovascular Nursing. 6(4), pp. 255 - 258. https://doi.org/10.1016/j.ejcnurse.2007.07.003
Understanding the experiences of mothers who are breast feeding an infant with tongue-tie: a hermeneutic phenomenology study.
Miles, Sandra and Fulbrook, Paul. (2007) Understanding the experiences of mothers who are breast feeding an infant with tongue-tie: a hermeneutic phenomenology study [Dataset].
Portable oxygen: Longer for less with oxymizer pendant
Fulbrook, Paul and Serginson, John. (2006) Portable oxygen: Longer for less with oxymizer pendant. Airways Journal (print version). 4(2), pp. 105 - 108.
Education for outreach: Development of an inter-professional MSC in critical care
Fulbrook, Paul and Cockerell, Janet. (2005) Education for outreach: Development of an inter-professional MSC in critical care. Nursing in Critical Care. 10(5), pp. 255 - 262. https://doi.org/10.1111/j.1362-1017.2005.00123.x
Advancing the clinical perspective: A practice development project to develop the nurse practitioner role in an acute hospital trust
Walsgrove, Hilary and Fulbrook, Paul. (2005) Advancing the clinical perspective: A practice development project to develop the nurse practitioner role in an acute hospital trust. Journal of Clinical Nursing. 14(4), pp. 444 - 455. https://doi.org/10.1111/j.1365-2702.2004.01089.x
Realizing advanced nursing practice through reflection
Fulbrook, Paul. (2004) Realizing advanced nursing practice through reflection. Nursing in Critical Care. 9(6), pp. 255 - 256. https://doi.org/10.1111/j.1362-1017.2004.00089.x
Developing a network protocol: Nurse-led weaning from ventilation
Fulbrook, Paul, Delaney, N., Rigby, J., Sowden, A., Trevett, M., Turner, L. and Whittam, A.. (2004) Developing a network protocol: Nurse-led weaning from ventilation. Connect: The world of Critical Care Nursing. 3(2), pp. 28 - 37.
Why do student nurses leave? Suggestions from a Delphi study
Fulbrook, Paul. (2003) Why do student nurses leave? Suggestions from a Delphi study. Nurse Education Today. 23(6), pp. 449 - 458. https://doi.org/10.1016/S0260-6917(03)00063-7
Developing best practice in critical care nursing: Knowledge, evidence and practice
Fulbrook, Paul. (2003) Developing best practice in critical care nursing: Knowledge, evidence and practice. Nursing in Critical Care. 8(3), pp. 96 - 102. https://doi.org/10.1046/j.1478-5153.2003.00010.x
Care bundles in critical care: A practical approach to evidence-based practice
Fulbrook, Paul and Mooney, Sharon. (2003) Care bundles in critical care: A practical approach to evidence-based practice. Nursing in Critical Care. 8(6), pp. 249 - 255. https://doi.org/10.1111/j.1362-1017.2003.00039.x