Abstract:

Objective To develop and validate a risk assessment tool for acute skin failure in ICU patients，aiming to provide a scientific assessment tool for evaluating the risk of acute skin failure in ICU patients. Methods Based on the theory of risk management，combined with literature review and Delphi expert consultation，an initial assessment tool was formed. Using convenience sampling，217 patients in the ICU of a tertiary general hospital in Shandong Province from June to July 2023 were selected as the research subjects，and item analysis and reliability and validity tests were conducted. A preliminary validation was carried out on 1，036 patients in the ICU of the same hospital from August 2023 to February 2024 to test the predictive value of the assessment tool and verify its predictive value. Results The assessment tool for acute skin failure in ICU patients included 6 first-level indicators and 15 second-level indicators. The Cronbach’s α coefficient of the tool was 0.757，and the content validity index was 0.940. The area under the receiver operating characteristic curve was 0.976（95%CI：0.968~0.985），Kappa coefficient was 0.861（P<0.001）. with a sensitivity of 92.1% and a specificity of 95.7%. The optimal cut-off value was 12 points，and the total score risk level was classified into low risk（12~15 points），medium risk 16~20 points），high risk（21~27 points）. The higher the score，the higher the risk of acute skin failure in ICU patients. Conclusion The risk assessment tool for ICU patients developed in this study has good reliability and validity，and has good sensitivity and practicality，which can effectively predict the occurrence of acute skin failure in ICU patients.

Key words: Intensive Care Unit, Acute Skin Failure, Risk Assessment, Delphi Method, Reliability and Validation, Nursing Care