Other Titles
Development and Psychometric Evaluation of a Medical Device–Related Pressure Injury Risk Assessment Scale (MedRAS) [Title Slide]
Abstract
Medical Device–Related Pressure Injuries (MDRPIs) pose a growing global challenge to patient safety, with incidence rates up to 19.3% [1]. MDRPIs are recognized as a nursing-sensitive quality indicator and excluded from hospital reimbursement systems, underscoring their clinical and economic significance [2,3]. Although largely preventable, accurate risk prediction remains limited due to the absence of MDRPI-specific tools for adults [4,5]. This study aimed to develop and validate a new, highly predictive risk assessment scale—MedRAS—to enable early identification and prevention of MDRPIs in adult inpatients.
This methodological and psychometric validation study included 160 adult inpatients using one or more medical devices. Data were analyzed in IBM SPSS Statistics 28.0. The initial 14-item scale was refined via binary logistic regression to identify significant predictors. Receiver Operating Characteristic (ROC) curve analysis evaluated discrimination (AUC, sensitivity, specificity), and the Youden Index determined the optimal cut-off. Reliability was tested using Cronbach’s alpha and Cohen’s kappa.
Logistic regression identified nine significant predictors forming the final MedRAS scale. It showed strong discriminative validity (AUC=0.844; 95% CI: 0.728–0.961; p<0.001). The cut-off score of 14.5 yielded 70.6% sensitivity and 88.8% specificity, minimizing false positives and supporting precise prevention. Three-tiered risk stratification (low, moderate, high) was significantly associated with MDRPI occurrence (χ2=37.267, p<0.001). Reliability analysis confirmed good internal consistency (α=0.80) and excellent inter-rater reliability (κ=0.806, p<0.001).
The MedRAS scale is a valid, reliable, and clinically applicable instrument for assessing MDRPI risk among adults. Its strong specificity and robust psychometric properties distinguish it from generic tools, supporting more precise preventive interventions. Integrating MedRAS into nursing assessments can enhance evidence-based practice, enabling early risk identification, prioritization of preventive care, and improved patient safety worldwide.
Notes
References:
[1] Zhang N, Li Y, Li X, Li F, Jin Z, Li T, Ma J. Incidence of medical device-related pressure injuries: a meta-analysis. European Journal of Medical Research. 2024 Aug 19;29(1):425.
[2] Caldwell S. Reducing Hospital-Acquired Pressure Injuries in a Cardiothoracic Intensive Care Unit. Critical Care Nurse. 2025 Feb 1;45(1):12-20.
[3] Padula WV, Pronovost PJ, Makic MB, Wald HL, Moran D, Mishra MK, Meltzer DO. Value of hospital resources for effective pressure injury prevention: a cost-effectiveness analysis. BMJ quality & safety. 2019 Feb 1;28(2):132-41.
[4] Gefen A, Alves P, Ciprandi G, Coyer F, Milne CT, Ousey K, Ohura N, Waters N, Worsley P. Device-related pressure ulcers: SECURE prevention. Journal of wound care. 2020 Feb 1;29(Sup2a):S1-52.
[5] Tschannen D, Anderson C. The pressure injury predictive model: a framework for hospital acquired pressure injuries. Journal of clinical nursing. 2020 Apr;29(7-8):1398-421.
Presenters have also authored an Open Access article on this same topic. It is available in this repository:
Karadağ, A., Uçanbelen, A., & Dalli, Ö. E. (2026). Development and Psychometric Evaluation of a Medical Device–Related Pressure Injury Risk Assessment Scale. International Wound Journal, 23(4), 1–13. https://doi-org.proxy.ulib.uits.iu.edu/10.1111/iwj.70918
Sigma Membership
Non-member
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Quantitative Research
Keywords:
Instrument and Tool Development, Implementation Science, Acute Care, Instrument Validation, Scale Development, Pressure Ulcer, Medical Devices, Psychometrics, Risk Assessment, Turkey
Recommended Citation
Karadag, Ayise; Uçanbelen, Aleyna; and Erbay Dalli, Öznur, "Development and Validation of a Risk Assessment Scale for Medical Device–Related Pressure Injuries" (2026). International Nursing Research Congress (INRC). 48.
https://www.sigmarepository.org/inrc/2026/presentations_2026/48
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-07-24
Development and Validation of a Risk Assessment Scale for Medical Device–Related Pressure Injuries
Toronto, Ontario, Canada
Medical Device–Related Pressure Injuries (MDRPIs) pose a growing global challenge to patient safety, with incidence rates up to 19.3% [1]. MDRPIs are recognized as a nursing-sensitive quality indicator and excluded from hospital reimbursement systems, underscoring their clinical and economic significance [2,3]. Although largely preventable, accurate risk prediction remains limited due to the absence of MDRPI-specific tools for adults [4,5]. This study aimed to develop and validate a new, highly predictive risk assessment scale—MedRAS—to enable early identification and prevention of MDRPIs in adult inpatients.
This methodological and psychometric validation study included 160 adult inpatients using one or more medical devices. Data were analyzed in IBM SPSS Statistics 28.0. The initial 14-item scale was refined via binary logistic regression to identify significant predictors. Receiver Operating Characteristic (ROC) curve analysis evaluated discrimination (AUC, sensitivity, specificity), and the Youden Index determined the optimal cut-off. Reliability was tested using Cronbach’s alpha and Cohen’s kappa.
Logistic regression identified nine significant predictors forming the final MedRAS scale. It showed strong discriminative validity (AUC=0.844; 95% CI: 0.728–0.961; p<0.001). The cut-off score of 14.5 yielded 70.6% sensitivity and 88.8% specificity, minimizing false positives and supporting precise prevention. Three-tiered risk stratification (low, moderate, high) was significantly associated with MDRPI occurrence (χ2=37.267, p<0.001). Reliability analysis confirmed good internal consistency (α=0.80) and excellent inter-rater reliability (κ=0.806, p<0.001).
The MedRAS scale is a valid, reliable, and clinically applicable instrument for assessing MDRPI risk among adults. Its strong specificity and robust psychometric properties distinguish it from generic tools, supporting more precise preventive interventions. Integrating MedRAS into nursing assessments can enhance evidence-based practice, enabling early risk identification, prioritization of preventive care, and improved patient safety worldwide.
Description
Medical device–related pressure injuries (MDRPIs) are increasingly common, yet generic risk tools lack accuracy for adults. We developed and validated a nine-item Medical Device–Related Pressure Injury Risk Assessment Scale (MedRAS) in 160 adult inpatients. MedRAS showed strong predictive validity (AUC=0.844, sensitivity 70.6%, specificity 88.8%) and good reliability (α=0.80), offering nurses an evidence-based tool for early prevention.