The Gosnell scale was developed to identify individuals living in extended care and over the age of 65 who were at risk for developing a pressure ulcer (Gosnell 1973). Patients are evaluated on five domains: 1) mental status, 2) continence, 3) mobility (the amount and control of movement of one's body), 4) activity (ability to ambulate) and 5) nutrition (the process of food intake). The evaluation also includes recording of: vital signs (which includes temperature pulse respirations and blood pressure), skin condition (which includes appearance, skin tone and sensation) and medications, but these are not scored. 

Number of items:N/a

Procedure/Administration: Raters indicate client status on each of the items (which could be based on personal experience or chart review). Scales are scored based on descriptive criteria provided on the scoring sheet. This produces a summary score from between 5 (worst prognosis) to 20 (best prognosis).

How scored: N/a

Interpretability: N/a

Acceptability: The scale omits items found to be important predictors of pressure ulcer development for people with SCI such as pulmonary disease, serum creatinine, extent of paralysis, severe spasticity, age, tobacco use/smoking, disease, cardiac disease, renal disease, and living in a nursing home or hospital.

Languages: N/a

Usability: If the data required is normally collected as part of patient care, items on the scale would not represent a burden to either the client or the assessor. If not, the scale would place considerable rater burden and some respondent burden.

Time to administer: N/a

Time to score: 5-10 minutes. The score is easy for a health care provider to calculate, but additional items such as the assessment of skin condition may require additional patient assessment. 

Training required: N/a

Availability: N/a

Equipment required: None

Summary: N/a

Psychometric Summary:

Note: TR= Test re-test; IC= Internal Consistency; Inter-O= Inter-observer; Intra-O= Intra-observer; SS= Sensitivity/Specificity.

Red light= A single study involving SCI subjects which has less than adequate findings of reliability, validity, and/or responsiveness.

Yellow light= A single study involving subjects with SCI which has adequate to excellent findings of reliability, validity, and/or responsiveness.

Green light= At least 2 studies involving subjects with SCI which have adequate to excellent findings of reliability, validity, and/or responsiveness.

N/a= No information.

References

• Gosnell DJ. An assessment tool to identify pressure sores. Nurs Res 1973;22:55-59.
• Salzberg CA, Byrne DW, Kabir R, van Niewerburg P, Cayten CG. Predicting pressure ulcers during initial hospitalization for acute spinal cord injury. Wounds 1999;11:45-57.
• Salzberg C A, Byrne DW, Cayten CG, van Niewerburgh P, Murphy JG, Viehbeck M. A new pressure ulcer risk assessment scale for individuals with spinal cord injury. Am J Phys Med Rehabil 1996;75:96-104.