Scripties UMCG - Rijksuniversiteit Groningen
English | Nederlands

Een onderzoek naar sensitiviteit en specificiteit van de geautomatiseerde monitoring van het decubitusrisico in het Erasmus MC

(2018) Hessels, R. (Rozemarijn)

In recent years the administrative burden in health care has significantly increased. We continue to measure more in order to be able to improve our health care. However, by doing this we lay a huge administrative burden on nursing staff. One of the most important performance indicators for nursing care is the prevalence of pressure ulcers. Prevention of pressure ulcers starts with a good risk assessment. Unfortunately, there’s no golden standard to assess this risk. In the Erasmus Medical Center we use the Waterlow scale to assess the risk. The 11-item scale is filled in for each in hospital patient, on the first day of administration and every 7th day in hospital. However, the vast majority of the patients has no risk at all or only a small risk for developing a pressure ulcer. Therefore, to improve the monitoring we developed a digital algorithm (‘decubitus alert’) that assesses this risk by collecting data from routinely entered data in the electronical patient’s file.
We investigated the safety and efficiency of this assessment. We included 1198 patients, of whom 41 developed a pressure ulcer (3,4%). Six of those patients weren’t recognized as a potential risk patient by the algorithm. Sensitivity and specificity has also been investigated, respectively 68,6% and 77,9%. Area under the receiver operating characteristic (ROC) is 0.791 (CI 0.7760 – 0.821, SE 0.016). With these values, the decubitus alert algorithm has similar screening characteristics as the Waterlow scale and can therefore be used in a safe and efficient way to monitor the risk for developing a pressure ulcer in in hospital patients.

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