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Development of a decision support tool to prevent community acquired pressure injuries for use in the spinal cord injury clinic using the delphi technique

Spinal Cord volume 61, pages 667–683 (2023)Cite this article

Subjects

Abstract

Study design

Delphi Technique.

Objectives

Describe the development of a decision support tool to prevent community-acquired pressure injuries (CAPrIs) in individuals with spinal cord injury (SCI) for use in SCI clinics, called the Community-Acquired Pressure Injury Prevention-Field Implementation Tool (CAPP-FIT).

Setting

Veteran Health Administration Hospital, Chicago, Illinois, USA.

Methods

Concept mapping of current pressure injury (PrI) guidelines and qualitative research describing risks, actions, and resources needed to prevent CAPrIs associated with SCI were used to develop 40 veteran checklist items (Items) along with 37 associated provider actions (Actions) for the tool. The Delphi technique was used to refine Items and Actions with a panel of interprofessional SCI providers (n = 15), veterans with SCI (n = 4), and caregivers (n = 3) to determine consensus on a 4-point Likert scale (strongly agree–strongly disagree) for each Item and Action. A 75% agreement was set for responses rated as strongly agree or agree.

Results

Panelists were 60% female, 62% White, 33% veterans with SCI or caregivers, 33% wound care certified with a mean age of 59 years. Two survey rounds were required for consensus for 41 Item and 38 Action CAPP-FIT. Response rate was 95% for both rounds. Delphi round 1 showed all but two Actions affirming agreement above 75%. Substantive comments from panelists required revision to 5 Items and 9 Actions and one additional Item/Actions related to coping, meeting threshold percent agreement in Round 2.

Conclusions

The CAPP-FIT could become a useful tool for Veterans living with SCI, caregivers, and SCI providers.

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Fig. 1: Example of CAPP-FIT Item and Actions: Skin Care Practice: Visual Assessment.
Fig. 2

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Data availability

More detailed datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

Funded by the VA HSR&D, IIR 16–267 Engaging Patients and Providers in Identifying and Addressing Modifiable Risk Factors to Prevent Community-Acquired Ulcers in Veterans with SCI. The views expressed in this manuscript are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government. The authors do not have commercial interests to disclose.

Author information

Authors and Affiliations

  1. Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, IL, USA

    Lisa Burkhart, Autumn Smith, Frances M. Weaver, Lisa Skemp & Sherri L. LaVela

  2. Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA

    Lisa Burkhart, Lisa Skemp & Amy Kiefer

  3. Spinal Cord Injury Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, USA

    Sameer Siddiqui

  4. H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA

    Sameer Siddiqui

  5. Edward Hines, Jr. VA Hospital, Hines, IL, USA

    Michael Richardson

  6. Spinal Cord Injury and Disorders Health Care Group (HCG) and Surgery HCG, VA Long Beach Healthcare System, Long Beach, CA, USA

    Walter Chua

  7. Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL, USA

    Frances M. Weaver & Lisa Skemp

  8. Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Sherri L. LaVela

  9. School of Nursing, University of California, Los Angeles, Los Angeles, CA, USA

    Barbara Bates-Jensen

  10. Division of Geriatrics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA

    Barbara Bates-Jensen

Authors
  1. Lisa Burkhart
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  2. Sameer Siddiqui
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  3. Autumn Smith
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  4. Michael Richardson
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  5. Karin Zachow
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  6. Walter Chua
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  7. Frances M. Weaver
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  8. Lisa Skemp
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  9. Amy Kiefer
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  10. Sherri L. LaVela
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  11. Barbara Bates-Jensen
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Contributions

All authors conceived and/or designed the work that led to the submission. LB, LS, AK, BBJ conducted the content analysis; BBJ, LB, AS conducted Delphi analysis; MR, WC, KZ, BBJ, SS, FW, SL contributed to initial drafts and revisions of the CAPP-FIT.

Corresponding author

Correspondence to Lisa Burkhart.

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Competing interests

The authors declare no competing interests.

Ethical approval

The Edward Hines, Jr. Veteran Health Administration Hospital Institutional review board approved this study.

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Burkhart, L., Siddiqui, S., Smith, A. et al. Development of a decision support tool to prevent community acquired pressure injuries for use in the spinal cord injury clinic using the delphi technique. Spinal Cord 61, 667–683 (2023). https://doi.org/10.1038/s41393-023-00937-8

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