Turkish Reliability and Validity of the Intensive Care Unit Specific Pressure Injury Risk Assessment Scale (RAPS-ICU): A Tool Validation

Abstract

Background: Pressure injuries are a major concern in intensive care units (ICUs), as critically ill patients are at high risk due to immobility and compromised health conditions. Accurate and reliable risk assessment tools, such as the Risk Assessment Pressure Injury Scale for the Intensive Care Unit (RAPS-ICU), are essential for early detection and prevention of pressure injuries in clinical practice.

Aim: This study aimed to determine the Turkish validity and reliability of the RAPS-ICU.

Study design: This was a tool validation study conducted with 62 patients hospitalised in the ICU of a Training and Research Hospital in Turkey. The RAPS-ICU was translated into Turkish, and its construct validity was evaluated using the content validity ratio (CVR) and content validity index (CVI). Further validation involved exploratory and confirmatory factor analyses (EFA, CFA). Reliability was assessed through internal consistency, inter-rater reliability, item-total correlation, and test-retest reliability.

Results: The Kaiser-Meyer-Olkin (KMO) value for the scale was 0.804, indicating sample adequacy. All item discrimination values were above 0.20, with factor loadings between 0.35 and 0.90. Cronbach's alpha coefficient was 0.825. Standard factor loadings ranged from 0.23 to 0.93, with root mean square error of approximation (RMSEA) = 0.086, comparative fit index (CFI) = 0.98, normed fit index (NFI) = 0.94, goodness-of-fit index (GFI) = 0.93, and standardised root mean square residual (SRMR) = 0.061. The CVI was 0.88, and the CVR exceeded the criterion value. The test-retest reliability coefficient was 0.933, and inter-rater reliability ranged from 0.78 to 0.87.

Conclusions: The Turkish version of the RAPS-ICU demonstrated established validity and reliability.

Relevance to clinical practice: The validated Turkish version of the RAPS-ICU provides a reliable and accurate tool for assessing pressure injury risk in intensive care settings. Its high reliability and validity support its use in clinical practice to enhance early detection and prevention strategies, ultimately improving patient outcomes. By integrating the RAPS-ICU into routine assessments, intensive care nurses can make more informed decisions regarding pressure injury prevention, optimising nursing care planning and patient safety in Turkish ICUs.

Keywords: intensive care; pressure injury; reliability; risk assessment; validity.