Korean J Adult Nurs.  2020 Feb;32(1):35-45. 10.7475/kjan.2020.32.1.35.

The Interrater Agreement for the Assessment of Pressure Ulcer Risk Using the Braden Scale and the Classification of Pressure Ulcers by Nurses in A Medium-Sized Hospital

• Na HJ
• Yoo SH
• Kwon YR
• Ahn MJ

• KMID: 2471027
• DOI: http://doi.org/10.7475/kjan.2020.32.1.35

Abstract

PURPOSE
This methodological study was conducted to evaluate the interrater agreement in pressure ulcer risk assessment using the Braden scale, and in pressure ulcer classification, by nurses in a medium-sized hospital.
METHODS
Data were collected from a medium-sized hospital, located in Seoul, from December 18, 2017 to February 28, 2018. The author (Rater 1) and 20 randomly sampled nurses (Rater 2) independently assessed 100 patients. The Braden scale for risk assessment and the six-stage pressure ulcer classification system were used. The interrater agreement was evaluated using the Intraclass Correlation Coefficient (ICC), the proportion of agreement (Po), and the Bland-Altman plots.
RESULTS
For the total score on the Braden scale, the ICC was .85 and the Po was .29. Among the scale items, "˜moisture' had the lowest agreement (ICC=.55, Po=.46). The interrater agreement had Po values of .84 and .69 for the presence and the classification of pressure ulcers, respectively.
CONCLUSION
For nurses in medium-sized hospitals, interrater agreement for the Braden scale and for the classification of pressure ulcers should be enhanced. In order to do this, overall institutional support is needed, including training in the accurate use of tools for pressure ulcer care.

MeSH Terms

Classification*
Humans
Methods
Observer Variation
Pressure Ulcer*
Risk Assessment
Seoul

Figure

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  Figure 1 Bland-Altman plots for braden scale score between raters.

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