Evaluation of the consistency of neonatal skin injury assessment using clinical images and the metric and graduated colour tool

August, Deanne, Kandasamy, Yogavijayan, Ray, Robin, New, Karen, and Lindsay, Daniel (2022) Evaluation of the consistency of neonatal skin injury assessment using clinical images and the metric and graduated colour tool. Journal of Tissue Viability, 31 (3). pp. 395-403.

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Aim: To evaluate consistency in the assessment of neonatal skin injuries.

Materials and methods: Injury images collected during a multicentre period prevalence study (n = 297) were screened for optimal quality before 60 images, stratified for size and colour, were randomly selected for assessment by three neonatal and two adult specialists. The principal investigator's assessments were the baseline for comparison and consistency. Injury characteristics and assessments were reported as descriptive statistics. Comparison of injury assessments for colour and stage were calculated using Chi-square, with p-value of <0.05 considered significant.

Results: Neonatal specialists assessed injury elements more confidently than adult specialists reporting 59–60 (98–100%) injuries visible compared to 51–53 (85–93%) respectively. Neonatal specialists attributed mechanical force to 93% of the skin injuries compared to 70% by adult specialists. Consistency of colour assessment was achieved more often with neonatal specialists (n = 50, 85%), compared to adult specialists (n = 41, 73%). Neonatal specialists’ consistency for injury staging (n = 107, 60%) was higher compared to adult specialists who were uncertain (n = 8,16%) and less consistent (n = 47, 44%). When comparing specialists as a group, consistency with baseline assessment was significantly different between neonatal and adult specialists for colour (p < 0.010) and injury stage (p < 0.009).

Conclusion: Field of expertise (neonatal versus adult) differences were noted likely related to experience and understanding of empirical differences between neonatal and adult skin structure and maturity. These results highlight the need for specialist neonatal skin injury and wound training for clinicians involved in assessment, treatment and best practices for neonates.

Item ID: 75656
Item Type: Article (Research - C1)
ISSN: 1876-4746
Keywords: Neonatal, skin injury, assessment consistency, colour, stage, colour reference, digital images
Copyright Information: © 2022 Published by Elsevier Ltd on behalf of Tissue Viability Society / Society of Tissue Viability.
Date Deposited: 08 Sep 2022 04:33
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3213 Paediatrics > 321303 Neonatology @ 100%
SEO Codes: 20 HEALTH > 2005 Specific population health (excl. Indigenous health) > 200506 Neonatal and child health @ 100%
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