Developing a Skin Classification Tool for Central Venous Access Devices
Central venous access devices (CVADs) are crucial for administering treatments to patients with complex medical conditions. However, they often lead to skin impairments like infections, pressure injuries, and dermatitis. This blog outlines the development of a new classification tool designed to standardize the identification and management of these skin impairments.
Study Overview
The study aimed to design and validate a comprehensive Central Venous Access Device-Associated Skin Impairment (CASI) classification tool. Using a two-phase Delphi method, experts from fields such as wound care and vascular access contributed their knowledge to ensure the tool's relevance and accuracy. The study incorporated a literature review followed by rounds of feedback and consensus from expert nurses, ensuring the tool's reliability.
Methodology
The research began with a literature review to gather evidence on skin impairments caused by CVADs. In the first phase, expert nurses reviewed existing terminologies and classifications. This was followed by a second phase where 38 clinical photographs were used to test the classification tool. The tool covers five broad categories of skin impairment: contact dermatitis, mechanical injury, infection, pressure injury, and complex clinical presentations.
Results
The final tool consists of 14 subcategories within the five overarching classifications. The expert panel agreed on the importance of standardizing skin impairment categories to reduce diagnostic confusion and enhance clinical decision-making. High levels of agreement were achieved among the experts, validating the tool’s content and inter-rater reliability.
Conclusion
The development of this CASI classification tool offers a standardized approach for healthcare providers. By offering clear guidelines for identifying and managing CVAD-related skin impairments, the tool is expected to improve patient outcomes by reducing misdiagnoses and treatment delays. As CVADs are frequently used in critical care, this tool will play a pivotal role in guiding clinical decisions and improving care quality.
Authors: Hui (Grace) Xu, Jill Campbell, Mari Takashima, Emily Larsen, Fiona Coyer, Deanne August, Anna Dean, Colleen Pitt, Bronwyn Griffin, Nicole Marsh, Claire M. Rickard, Amanda Ullman
Read More:https://onlinelibrary.wiley.com/doi/10.1111/jan.16416
