Abstract: Objective: To develop a risk assessment scale for iatrogenic skin injury in critically ill neonates, providing an objective tool for effectively evaluating the risk of iatrogenic skin injury in this population. Methods: The initial scale was designed based on a review of similar existing scales, using literature analysis, semi-structured interviews, and expert group discussions. A two-round Delphi method was employed to consult 20 experts and finalize the scale′s items and scoring methods. Results: The recovery rates of valid questionnaires, the expert authority coefficients, and the Kendall′s coefficients of concordance in the two rounds of inquiry were 90.9% and 100%, 0.84 and 0.91, 0.208 and 0.249, respectively (P<0.001). The final scale consists of six dimensions, including physiological condition, skin condition, current body status, risk factors for medical adhesive-related skin injury, risk factors for drug extravasation injury, and risk factors for medical device-related injuries. The scale includes 22 items, with importance scores ranging from 4.10 to 4.90, coefficient variations ranging from 0.060 to 0.207, and the full score rate between 45% and 90%. Conclusion: The iatrogenic skin injury risk assessment scale for critically ill neonates developed based on the Delphi method demonstrates high scientific rigor and authority. It can be used to assess the risk of iatrogenic skin injuries in critically ill neonates.

Key words: Critically ill neonates, Iatrogenic skin injury, Risk assessment, Delphi, Scale

摘要： 目的：编制危重症新生儿医源性皮肤损伤风险评估量表，为有效评估危重症新生儿发生医源性皮肤损伤的风险提供客观测评工具。方法：以既往类似量表为雏形，采用文献分析、半结构式访谈和专家小组讨论法编制初始量表，通过2轮德尔菲法对20名专家进行函询确定量表条目及评分方法。结果：2轮函询的有效问卷回收率分别为90.9%、100%；专家权威系数分别为0.84、0.91；肯德尔和谐系数分别为0.208、0.249（P<0.001）。最终形成的量表包括生理状况、皮肤状况、当前机体状况、医用粘胶相关性皮肤损伤风险要素、药物外渗性皮肤损伤风险要素和医疗器械相关性皮肤损伤风险要素共6个维度，包含22个条目，各条目重要性评分为4.10 ~ 4.90 分，变异系数为0.060 ~ 0.207，满分率为45% ~ 90%。结论：基于德尔菲法编制的危重症新生儿医源性皮肤损伤风险评估量表具有较高的科学性和权威性，可用于评估危重症新生儿发生医源性皮肤损伤的风险。

关键词: 重症监护室, 新生儿；皮肤损伤, 医源性；风险评估；德尔菲；量表