Pressure Ulcer Scale for Healing (PUSH): interobserver reliability in the evaluation of venous ulcers

Abstract

The aim of this study was to evaluate interobserver reliability of the Pressure Ulcer Scale for Healing (PUSH) tool, in patients with venous ulcers. This methodological research was conducted in outpatient health care units, between June 2016 and August 2017. The participants were 10 nurses, who performed 46 observations of 35 wounds. Each observation was performed by a reference nurse, who provided the gold standard evaluation, and two clinical nurses participating in the research as subjects. To analyze the level of agreement, the Kappa index and intraclass correlation coefficient were used. Kappa values of the subscales ranged from 0.6 to 0.85 (p <0.001). There was almost perfect interobserver agreement for "area" and "exudate quantity" and substantial interobserver agreement for "tissue type" and "total score". The intraclass correlation coefficients were > 0.9, indicating excellent reliability. It is, thus, concluded that the PUSH presents satisfactory interobserver reliability for evaluating venous ulcers.