Introduction: Early identification of pressure ulcers (PUs) is essential to provide timely therapeutic interventions and customized preventive measures for bedridden patients in the ICU. However, the current PU assessment tools lack transparency and objectivity, so developing a comprehensive and reliable tool suitable for ICU patients is necessary. The purpose of the protocol study is to demonstrate the design process of an assessment tool for predicting PUs in ICU bedridden patients using a multi-method approach.
Methods: This study will employ a sequential multi-method research design comprising three stages: a scoping review, Delphi methods, and a cross-sectional study. In the first stage, the scoping review examined ICU patients' risk factors for PUs. It will also identify potential predictors for PUs based on relevant published studies. Moving onto the second stage, a panel of experts in the field evaluated these predictors through three consecutive Delphi rounds. Their opinions will be considered, and any new factors suggested will be added to the list. The third Delphi round will aim to achieve over 75% agreement among the experts, resulting in the final version of the potential predictor list. Lastly, in the third stage, a cross-sectional study was conducted to assess the relative contribution of potential predictors to the development or worsening of PUs in ICU patients. The information and results from this study will be used to develop a pressure ulcer assessment tool for bedridden patients in ICUs.
Discussion: This study employs a multi-method approach that combines various assessment tools, including comprehensive reviews, expert opinions, and objective clinical measurements. The resulting assessment tool will enable clinicians to predict the occurrence of PUs accurately, implement personalized preventive strategies and optimize resource allocation. Enhancing early detection and prevention of PUs can significantly improve patient well-being, reduce healthcare burdens, and achieve better long-term outcomes.