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An Instrument to Measure Healing in Pressure Ulcers

Development and Validation of the Pressure Ulcer Scale for Healing (PUSH)

^a School of Nursing, University of California–San Francisco
^b Plastic Surgery Research, University of Virginia Medical Center, Charlottesville
^c Division of Geriatrics, Saint Louis University, Missouri
^d College of Nursing, University of Iowa, Iowa City
^e University of Alabama–Birmingham
^f Sussman Physical Therapy, Inc., Torrance, California
^g University of California–Los Angeles
^h College of Nursing, University of Nebraska, Omaha
ⁱ Harper Hospital/Detroit Medical Center, Detroit, Michigan

Nancy A. Stotts, University of California–San Francisco, School of Nursing, 2 Koret Way, Room 631, Box 0610, San Francisco, CA 94143-0610 E-mail: nancy.stotts{at}nursing.ucsf.edu.

Decision Editor: John E. Morley, MB, BCh

Background. Currently, there is no instrument that provides an accurate and simple method of monitoring pressure ulcer healing in clinical practice. This article reports the two studies that were conducted to assess the validity of the Pressure Ulcer Scale for Healing (PUSH) as a tool to monitor healing of stage II–IV pressure ulcers.

Methods. Subjects in both studies (N = 103 and N = 269) were elderly (mean Study 1, 75 years, mean Study 2, 80 years), and the majority were women (Study 1, 51%, Study 2, 70%). Study data were extracted from patients' permanent records.

Results. Principal components analysis confirmed that the PUSH tool accounted for 58% to 74% of the wound healing variance over a 10-week period in Study 1 and 40% to 57% of the wound healing variance over a 12-week period in Study 2. In addition, multiple regression analysis, used to measure the sensitivity of the model to total healing, showed PUSH accounted for 39% of the variance in 6 weeks and 31% of the variance over 12 weeks (p < .001; Studies 1 and 2, respectively).

Conclusions. Data from these two studies confirmed that the PUSH tool, with the components of length times width, exudate amount, and tissue type, is a valid and sensitive measure of pressure ulcer healing. It is a practical approach that provides clinically valid data regarding pressure ulcer healing. Further testing is needed to confirm these findings.

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				S. E. Gardner, R. A. Frantz, S. Bergquist, and C. D. Shin A Prospective Study of the Pressure Ulcer Scale for Healing (PUSH) J. Gerontol. A Biol. Sci. Med. Sci., January 1, 2005; 60(1): 93 - 97. [Abstract] [Full Text] [PDF]

				J. E. Morley, J. H. Flaherty, and D. R. Thomas Editorial: Geriatricians, Continuous Quality Improvement, and Improved Care for Older Persons J. Gerontol. A Biol. Sci. Med. Sci., September 1, 2003; 58(9): M809 - 812. [Full Text] [PDF]

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