A Case for Using Evidence-Based Assessment Scales

Fecal incontinence is often difficult to manage in patients in the intensive care unit. The authors of the preceding study, “Clinical Evaluation of a Flexible Fecal Incontinence Management System,”¹ should be applauded for testing a promising new device to address this difficult problem. The study may have been further strengthened, however, with the addition of 2 evidence-based assessment scales: the Braden Scale for Predicting Pressure Ulcer Risk² and the National Pressure Ulcer Advisory Panel’s (NPUAP’s) Staging System for Pressure Ulcers.³ Both tools have been tested repeatedly and have shown adequate validity and reliability.

The authors state that “[f]ecal incontinence is an established risk factor for pressure ulcers....”^1 (p385) Of the 3 studies cited to support their assertion, one identified 21 additional pressure ulcer risk factors in the critically ill.⁴ Currently, fecal incontinence is considered one of many pressure ulcer risk factors, with the 2 major...