Akademik Veri Yönetim Sistemi
Intensive and Critical Care Nursing, cilt.83, ss.1-6, 2024 (SCI-Expanded)
Objectives: To assess the interrater reliability of the COMHON (level of COnciousness, Mobility, Haemodynamics,
Oxygenation, Nutrition) Index pressure injury risk assessment tool.
Design: Interrater reliability was tested. Twenty-five intensive care patients were each assessed by five different
nurse-raters from a pool of intensive care nurses who were available on the days of assessment. In total, 25 nurses
participated.
Setting: Two general and one cardiovascular surgery intensive care units in Istanbul, Turkey.
Main outcome measures: Interrater reliability was analysed using intraclass correlations, and standard errors of
measurement (SEM) were calculated for sum scores, risk level and item scores. Minimally detectable change
(MDC) was also calculated for sum score. Consistency between paired raters was analysed using Pearson’s
Product Moment Correlation (r) for sum score and Spearman’s rho (rs) for ordinal variables.
Results: All assessments were completed in ≤5 min. Interrater reliability was very high [ICC (1,1) = 0.998 (95 %
CI 0.996 – 0.999)] with a SEM of 0.14 and MDC of 0.39. Consistency between paired raters was strong for sum
and item scores and risk levels (coefficients >0.6). All scale items showed correlations of >.3 with the sum score.
Conclusion: The results demonstrate near-perfect interrater reliability. Further research into the psychometric
properties of the COMHON Index and its impact on preventative intervention use is warranted.
Implications for clinical practice: Pressure injury risk assessment within intensive care should be setting-specific
due to the unique risk factors inherent to the patient population, which are not considered by general pressure injury risk assessment tools.
An intensive care-specific pressure injury risk assessment tool was tested and demonstrated high reliability between intensive care nurses.
Further research is needed to understand how its use in practice affects preventative intervention implementation and, in turn, how it impacts pressure injury outcomes