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Frailty in community-dwelling individuals often leads to prolonged periods in bed or sitting, increasing their risk of pressure injury development. The Quality Improvement project ‘Pressure Reduction through cOntinuous Monitoring In the community SEtting’ (PROMISE) implemented the use of continuous pressure monitoring (CPM) to inform interventions. A secondary analysis of PROMISE data involving 17 patients was examined before and after the intervention. A novel algorithm using duration and magnitude of pressure signatures at the buttock area was estimated from the CPM data and an algorithm based on the sigmoid relationship between pressure and time was used to categorise risk pre- to post-intervention. The CPM intervention helped inform changes in support surface, posture and mobility advice. Duration and magnitude of pressure signatures revealed a high degree of inter-subject variability. At baseline 35% of (6/17) patients spent prolonged periods with potentially harmful interface pressures (high to very high exposure). Trends of improvements post-PROMISE intervention were observed, with 24% (4/17) in these higher exposure categories. This study demonstrated how CPM could be used to inform interventions for individuals living with pressure injuries in the community. An algorithm was used to understand trends in posture, mobility, and pressure exposure, showing some improvement pre- to post-intervention.
The study aimed to translate the PUKAT 2.0 tool from English to Italian. This was an adaptation and validation study; the validity of the Italian version was determined through content validity, item validity and construct validity. The reliability of the instrument was assessed by conducting a test–retest analysis on a sample of 62 nurses. The I-CVI indices were above the threshold of 0.78 for 91% of the questions, and according to the S-CVI index, 96% of the evaluators agreed that the questionnaire was highly relevant. The overall values for item difficulty were good, with two items being too difficult and none being too easy. The item discriminant index was overall good and reasonable, low for four items. The overall ICC was poor to moderate with a value of 0.48 (95% CI 0.26–0.65). The instrument has proven to be a good starting point although not yet completely reliable, as it clearly requires more basic preparation on the part of the staff, further modifications regarding the reliability and clarity of the questions and more training of the nursing staff if it is to be used in the Italian context.
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