Neonatal skin injury scales: a scoping review with narrative synthesis protocol

Abstract

Background Mechanical skin injuries have been a neonatal complication since the 1980s but a number of factors affect their assessment, particularly the assessment of injury severity. Whilst there is a single severity and classification system used to assess adult pressure injuries within Australia, there are no neonatal-specific standards for injury assessment. Unfortunately, neonates sustain skin injuries frequently and, whilst there are some similarities to adult injuries, the maturity of neonatal skin puts the application of adult injury scales into question. In addition, several severity systems are currently utilised, thus outcomes for skin injury prevention or management strategies are difficult to compare. Aims This review will investigate severity scales used for neonatal skin injury. Secondly, this review will determine the (i) characteristics of severity scales such as ordinal or categorical groupings and (ii) assessment of scale validation for population. Methods This scoping review will utilise the PRISMA-ScR framework and the 2015 Joanna Briggs Institute methodology. The electronic medical databases chosen are PubMed, CINAHL, COCHRANE Central and Scopus. Publications from within the last 20 years will be included to ensure the scales and the neonatal population reflect the timepoint when neonatal skin care became a safety and quality outcome as recognised by international seminal works.