Psychometric Research in Creating a Decision Support Tool to Prevent Community Acquired Pressure Injuries for Use in the Spinal Cord Injury Clinic

Abstract Study Design: Psychometric; Concept Mapping, Delphi Technique Objectives Describe the development and validation of a decision support tool to prevent community-acquired pressure injuries (CAPrIs) in individuals with spinal cord injury (SCI) for use in SCI clinics, called the Community-Acquired Pressure Injury Prevention-Field Implementation Tool (CAPP-FIT). Setting: Veteran Health Administration Hospital, Chicago, Illinois, USA Methods Concept mapping of current pressure injury (PrI) guidelines and qualitative research describing risks, actions, and resources needed to prevent CAPrIs associated with SCI were used to develop 14 veteran checklist items (Items) along with 11 associated provider actions (Actions) for the tool. The Delphi technique was used to validate Items and Actions with a panel of interprofessional SCI providers (n = 15), veterans with SCI (n = 4), and caregivers (n = 3) to determine consensus on a 4-point Likert scale (strongly agree–strongly disagree) for each Item and Action. A 75% agreement was set for responses rated as strongly agree or agree. Results Panelists were 60% female, 65% Black, 30% wound care certified with a mean age of 59 years. Two survey rounds were required for consensus. Response rate was 95% for both rounds. Delphi round 1 showed all Items and Actions affirmed agreement above 75% with comments requiring a second round reaching 83% agreement. The CAPP-FIT includes a 14-item computerized Veteran survey and generates a Provider report of veteran responses with recommended actions to guide provider decision-making. Conclusions The CAPP-FIT achieved face and content validity for accuracy, usability and acceptability by veterans living with SCI, caregivers, and SCI providers.