Inter-rater reliability of the Reaper Oral Mucosa Pressure Injury Scale (ROMPIS): A novel scale for the assessment of the severity of pressure injuries to the mouth and oral mucosa

Sue Reaper, Cameron Green, Sachin Gupta, Ravindranath Tiruvoipati

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background Patients who are intubated in the ICU are at risk of developing pressure injuries to the mouth and lips from endotracheal tubes. Clear documentation is important for pressure wound care; however, no validated instruments currently exist for the staging of pressure injuries to the oral mucosa. Instruments designed for the assessment of pressure injuries to other bodily regions are anatomically unsuited to the lips and mouth. Objectives This study aimed to develop and then assess the reliability of a novel scale for the assessment of pressure injuries to the mouth and oral mucosa. Methods The Reaper Oral Mucosa Pressure Injury Scale (ROMPIS) was developed in consultation with ICU nurses, clinical nurse educators, Intensivists, and experts in pressure wound management. ICU nurses and portfolio-holders in pressure wound care from Peninsula Health (Victoria, Australia) were invited to use the ROMPIS to stage 19 de-identified clinical photographs of oral pressure injuries via secure online survey. Inter-rater reliability (IRR) was calculated using Krippendorff's alpha (α). Results Among ICU nurses (n = 52), IRR of the ROMPIS was α = 0.307; improving to α = 0.463 when considering only responses where injuries were deemed to be stageable using the ROMPIS (i.e. excluding responses where respondents considered an injury to be unstageable). Among a cohort of experts in pressure wound care (n = 8), IRR was α = 0.306; or α = 0.443 excluding responses indicating that wounds were unstageable. Conclusions An instrument for the assessment and monitoring of pressure injuries to the mouth and lips has practical implications for patient care. This preliminary study indicates that the ROMPIS instrument has potential to be used clinically for this purpose; however, the performance of this scale may be somewhat reliant on the confidence or experience of the ICU nurse utilising it. Further validation is required.

Original languageEnglish
Pages (from-to)167-171
Number of pages5
JournalAustralian Critical Care
Volume30
Issue number3
DOIs
Publication statusPublished - 1 May 2017

Keywords

  • Assessment
  • Critical care
  • Inter-rater reliability
  • Pressure injury
  • Pressure wound
  • Quality

Cite this

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title = "Inter-rater reliability of the Reaper Oral Mucosa Pressure Injury Scale (ROMPIS): A novel scale for the assessment of the severity of pressure injuries to the mouth and oral mucosa",
abstract = "Background Patients who are intubated in the ICU are at risk of developing pressure injuries to the mouth and lips from endotracheal tubes. Clear documentation is important for pressure wound care; however, no validated instruments currently exist for the staging of pressure injuries to the oral mucosa. Instruments designed for the assessment of pressure injuries to other bodily regions are anatomically unsuited to the lips and mouth. Objectives This study aimed to develop and then assess the reliability of a novel scale for the assessment of pressure injuries to the mouth and oral mucosa. Methods The Reaper Oral Mucosa Pressure Injury Scale (ROMPIS) was developed in consultation with ICU nurses, clinical nurse educators, Intensivists, and experts in pressure wound management. ICU nurses and portfolio-holders in pressure wound care from Peninsula Health (Victoria, Australia) were invited to use the ROMPIS to stage 19 de-identified clinical photographs of oral pressure injuries via secure online survey. Inter-rater reliability (IRR) was calculated using Krippendorff's alpha (α). Results Among ICU nurses (n = 52), IRR of the ROMPIS was α = 0.307; improving to α = 0.463 when considering only responses where injuries were deemed to be stageable using the ROMPIS (i.e. excluding responses where respondents considered an injury to be unstageable). Among a cohort of experts in pressure wound care (n = 8), IRR was α = 0.306; or α = 0.443 excluding responses indicating that wounds were unstageable. Conclusions An instrument for the assessment and monitoring of pressure injuries to the mouth and lips has practical implications for patient care. This preliminary study indicates that the ROMPIS instrument has potential to be used clinically for this purpose; however, the performance of this scale may be somewhat reliant on the confidence or experience of the ICU nurse utilising it. Further validation is required.",
keywords = "Assessment, Critical care, Inter-rater reliability, Pressure injury, Pressure wound, Quality",
author = "Sue Reaper and Cameron Green and Sachin Gupta and Ravindranath Tiruvoipati",
year = "2017",
month = "5",
day = "1",
doi = "10.1016/j.aucc.2016.06.003",
language = "English",
volume = "30",
pages = "167--171",
journal = "Australian critical care : official journal of the Confederation of Australian Critical Care Nurses",
issn = "1036-7314",
publisher = "Elsevier",
number = "3",

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T1 - Inter-rater reliability of the Reaper Oral Mucosa Pressure Injury Scale (ROMPIS)

T2 - A novel scale for the assessment of the severity of pressure injuries to the mouth and oral mucosa

AU - Reaper, Sue

AU - Green, Cameron

AU - Gupta, Sachin

AU - Tiruvoipati, Ravindranath

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Background Patients who are intubated in the ICU are at risk of developing pressure injuries to the mouth and lips from endotracheal tubes. Clear documentation is important for pressure wound care; however, no validated instruments currently exist for the staging of pressure injuries to the oral mucosa. Instruments designed for the assessment of pressure injuries to other bodily regions are anatomically unsuited to the lips and mouth. Objectives This study aimed to develop and then assess the reliability of a novel scale for the assessment of pressure injuries to the mouth and oral mucosa. Methods The Reaper Oral Mucosa Pressure Injury Scale (ROMPIS) was developed in consultation with ICU nurses, clinical nurse educators, Intensivists, and experts in pressure wound management. ICU nurses and portfolio-holders in pressure wound care from Peninsula Health (Victoria, Australia) were invited to use the ROMPIS to stage 19 de-identified clinical photographs of oral pressure injuries via secure online survey. Inter-rater reliability (IRR) was calculated using Krippendorff's alpha (α). Results Among ICU nurses (n = 52), IRR of the ROMPIS was α = 0.307; improving to α = 0.463 when considering only responses where injuries were deemed to be stageable using the ROMPIS (i.e. excluding responses where respondents considered an injury to be unstageable). Among a cohort of experts in pressure wound care (n = 8), IRR was α = 0.306; or α = 0.443 excluding responses indicating that wounds were unstageable. Conclusions An instrument for the assessment and monitoring of pressure injuries to the mouth and lips has practical implications for patient care. This preliminary study indicates that the ROMPIS instrument has potential to be used clinically for this purpose; however, the performance of this scale may be somewhat reliant on the confidence or experience of the ICU nurse utilising it. Further validation is required.

AB - Background Patients who are intubated in the ICU are at risk of developing pressure injuries to the mouth and lips from endotracheal tubes. Clear documentation is important for pressure wound care; however, no validated instruments currently exist for the staging of pressure injuries to the oral mucosa. Instruments designed for the assessment of pressure injuries to other bodily regions are anatomically unsuited to the lips and mouth. Objectives This study aimed to develop and then assess the reliability of a novel scale for the assessment of pressure injuries to the mouth and oral mucosa. Methods The Reaper Oral Mucosa Pressure Injury Scale (ROMPIS) was developed in consultation with ICU nurses, clinical nurse educators, Intensivists, and experts in pressure wound management. ICU nurses and portfolio-holders in pressure wound care from Peninsula Health (Victoria, Australia) were invited to use the ROMPIS to stage 19 de-identified clinical photographs of oral pressure injuries via secure online survey. Inter-rater reliability (IRR) was calculated using Krippendorff's alpha (α). Results Among ICU nurses (n = 52), IRR of the ROMPIS was α = 0.307; improving to α = 0.463 when considering only responses where injuries were deemed to be stageable using the ROMPIS (i.e. excluding responses where respondents considered an injury to be unstageable). Among a cohort of experts in pressure wound care (n = 8), IRR was α = 0.306; or α = 0.443 excluding responses indicating that wounds were unstageable. Conclusions An instrument for the assessment and monitoring of pressure injuries to the mouth and lips has practical implications for patient care. This preliminary study indicates that the ROMPIS instrument has potential to be used clinically for this purpose; however, the performance of this scale may be somewhat reliant on the confidence or experience of the ICU nurse utilising it. Further validation is required.

KW - Assessment

KW - Critical care

KW - Inter-rater reliability

KW - Pressure injury

KW - Pressure wound

KW - Quality

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U2 - 10.1016/j.aucc.2016.06.003

DO - 10.1016/j.aucc.2016.06.003

M3 - Article

VL - 30

SP - 167

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JO - Australian critical care : official journal of the Confederation of Australian Critical Care Nurses

JF - Australian critical care : official journal of the Confederation of Australian Critical Care Nurses

SN - 1036-7314

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