Change search
ReferencesLink to record
Permanent link

Direct link
Nursing assistants: "He seems to be ill" - a reason for nurses to take action: validation of the Early Detection Scale of Infection (EDIS)
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in East Östergötland, Department of Advanced Home Care in Norrköping. Region Östergötland, Local Health Care Services in East Östergötland, Center of Palliative Care.
Uppsala University, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Immunology and Transfusion Medicine.
Show others and affiliations
2015 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 15, no 122Article in journal (Refereed) Published
Abstract [en]

Background: Signs and symptoms of infection in frail elderly are atypical, causing delay in diagnosis and treatment. To improve communication between healthcare staff of signs and symptoms of infection we developed an instrument, using qualitative data from observations by nursing assistants when they suspected infection. The aim of this study was to assess the validity of nursing assistants observations by developing and testing the instrument for early detection of infection in elderly nursing home residents. Methods: The early detection of infection (EDIS) instrument was based on data from focus interviews with nursing assistants. Over one year the nursing assistants used EDIS to document episodes of suspected early signs and symptoms of infection in 204 nursing home residents. Two physicians classified documented episodes as "no infection", "possible infection", and "infection". The content validity of the 13 items of the EDIS was established to explore the relationships between the items. The construct validity was used to explore the relationship between the items and the presence or absence of infection. The predictive value of the developed model was evaluated by the percentage of correct classifications of the observed cases. Generalized linear model (ordinal multinomial distribution and logit link) was used. Results: Of the 388 events of suspected infection, 20 % were assessed as no infection, 31 % as possible infection and 49 % as infection. Content validity analysis showed that 12/13 of the items correlated significantly with at least one other statement. The range in number of significant inter-correlations was from 0 ("pain") to 8 ("general signs and symptoms of illness"). The construct validity showed that the items "temperature", "respiratory symptoms" and "general signs and symptoms of illness" were significantly related to "infection", and these were also selected in the model-building. These items predicted correct alternative responses in 61 % of the cases. Conclusion: The validation of EDIS suggests that the observation of "general signs and symptoms of illness", made by nursing assistants should be taken seriously in detecting early infection in frail elderly. Also, the statement "He/She is not as usual" should lead to follow-up.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD , 2015. Vol. 15, no 122
Keyword [en]
Nursing home residents; Clinical assessment; Instrument validation; Instrument construction
National Category
Clinical Medicine Sociology
URN: urn:nbn:se:liu:diva-122527DOI: 10.1186/s12877-015-0114-0ISI: 000362866800002PubMedID: 26459627OAI: diva2:868018

Funding Agencies|Medical Research Council of Southeast Sweden; Futurum/The Academy for Health and Care, Jonkoping County, Sweden

Available from: 2015-11-09 Created: 2015-11-06 Last updated: 2016-04-24

Open Access in DiVA

fulltext(716 kB)46 downloads
File information
File name FULLTEXT01.pdfFile size 716 kBChecksum SHA-512
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Tingström, PiaMilberg, AnnaErnerudh, JanGrodzinsky, EwaSund-Levander, Märtha
By organisation
Division of Nursing ScienceFaculty of Medicine and Health SciencesDivision of Health, Activity and CareDepartment of Advanced Home Care in NorrköpingCenter of Palliative CareDivision of Neuro and Inflammation ScienceDepartment of Clinical Immunology and Transfusion MedicineDivision of Drug ResearchResearch & Development Unit in Local Health Care
In the same journal
BMC Geriatrics
Clinical MedicineSociology

Search outside of DiVA

GoogleGoogle Scholar
Total: 46 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 175 hits
ReferencesLink to record
Permanent link

Direct link