Identifying Candidate Predictors of Hospital-Acquired Pressure Injuries among Adult, Medical-Surgical Patients Using Clinical Expert Knowledge: A Delphi Study.
Urszula A Snigurska, Ragnhildur I Bjarnadottir, Ann L Horgas and 2 others
PMID 41540579WHAT IT FOUND
A panel of 16 clinicians agreed that 132 of 205 concepts are important for assessing pressure injury risk.
Activity, age, mobility, moisture, skin condition, friction and shear, and repositioning reached 100% agreement. These are expert opinions on what to look for, not tested predictors.
Key findings
01More than half of the panelists agreed that 132 of 205 concepts were clinically important when assessing hospital-acquired pressure injury risk.
02Activity, age, history of previous pressure injury, mobility, moisture, number of existing pressure injuries, paraplegia, pressure injury on admission, skin condition and spinal cord injury reached 100% agreement as predisposing factors.
03Friction and shear, immobilization due to a cast or orthopedic device, and repositioning reached 100% agreement as precipitating factors, meaning clinician interventions that can inadvertently contribute to pressure injury development.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
Only one reviewer performed the initial concept extraction, so the reliability of that step was not independently verified. The study did not measure response stability because concepts that reached consensus were removed from subsequent rounds. The panel was small (16 members) and recruited via snowball sampling from a single academic medical center network, limiting generalizability. The study is exploratory. It identifies what experts think is important, not what actually predicts pressure injuries empirically. The term 'important' reflects subjective expert opinion and does not imply empirical validation.
Declared interests
The authors report no conflicts of interest. No external funding source is named in the provided text.
The easy way to misread this
Do not treat these 132 concepts as validated predictors of pressure injury risk. The study reports what a small panel of clinicians believes is important based on experience, not what has been empirically tested. The authors themselves state that these concepts must now be tested to identify which are true predictors.