Risk Assessment Scale for the Development of Medical Adhesive-related Skin Injuries.
Maíla Fidalgo de Faria, Talita Silva Alves Tibola, Maria Beatriz Guimarães Raponi and 3 others
PMID 41259551WHAT IT FOUND
A new 48-item scale identified hospitalized adults at higher risk of skin injury from medical adhesives.
A score of 11 or more marked high risk, and high-risk patients were more likely to develop injury.
Key findings
01The final ERLAM has 48 items, scores from zero to 48, and a score of 11 or higher classifies high risk for MARSI.
02In 329 patients, high-risk ERLAM classification at the 11-point cut-off was associated with 8.14 times higher likelihood of MARSI, with sensitivity of 86% and specificity of 57%.
03The scale showed excellent agreement between observers, with an ICC of 0.92, and 39 items had the best agreement indices.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The scale was developed and validated only in Brazilian Portuguese, so its wording and cut-off may not transfer directly to other languages or settings. No other validated MARSI risk scale was available for adults to compare against, so concurrent validity was not assessed. The study was done in three intensive care units and a surgical clinic at a public teaching hospital in Brazil. Patients with pre-existing skin changes at the adhesive site were excluded, so the scale was not tested in those patients. Skin assessments occurred only during adhesive changes at bathing times, not during all adhesive changes. Interobserver reliability was tested in only 32 patients. Specificity was 57%, and 80 patients classified as high risk did not develop injury. Final content validation involved three judges after four withdrew.
The easy way to misread this
Do not read a high ERLAM score as proof that an adhesive injury is certain. Specificity was 57%, and 80 patients classified as high risk did not develop injury. The scale was developed to classify risk, not to test prevention.