Predictive Performance of Device-Neonatal Skin Risk Assessment Scale to Evaluating Pressure Injuries Risk in the Neonates. An Observational Multicenter Study.
Biagio Nicolosi, Elisa Neri, Leonardo Fioravanti and 4 others
PMID 40346751WHAT IT FOUND
In 137 NICU neonates, 9 developed pressure injuries, mostly from devices.
A device-adjusted score ≤11 in the first 24 hours predicted injuries better than Glamorgan.
Key findings
01Nine of 137 newborns developed 16 pressure injuries, and 12 of 16 lesions were device-related.
02During the first 24 hours, a Dev-NSRAS score of 11 or less showed very good discrimination for later pressure injuries (AUC 0.921, 81.6% sensitivity, 93.6% specificity), compared with moderate discrimination for a Glamorgan score above 28 (AUC 0.752, 92.1% sensitivity, 65.5% specificity).
03Newborns who developed pressure injuries were more premature, lighter at birth and had longer stays than those who did not.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 9 newborns developed pressure injuries, so the predictive accuracy rests on a small number of events. The study did not compare Dev-NSRAS with the original NSRAS. No inter-rater variability assessment for Dev-NSRAS was reported. Nurses were not blinded to risk scores. Some records were discarded as incomplete.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the better prediction as proof that using the scale prevents pressure injuries. This was an observational study of 137 newborns with only 9 injuries, so it tested prediction, not prevention.