Table 9.

Summary of expert nurse field notes

Characteristic	Positive aspects of using PURPOSE	Problem aspects of using PURPOSE T
Layout	Easy to use and self‐explanatory Quick to use Easier to use with familiarity All on one page	Tool looked “busy” or “complicated” Font size small Space for skin assessment too small
Format	The RAG rating approach for assessment decision and use of colour made distinctive Like the fact it did not use a score like other risk assessment scales	Form does not flow Unclear whether to progress to Step 2 Concern that exiting at Step 1 would miss assessment of important risk factors Nurses wanted to complete full skin assessment at step 1
Content	Thorough and included important risk factors Positive about the detailed skin assessment and suggested that this encouraged more careful skin assessment Inclusion of pressure ulcer scar as a risk factor	Reliability of assessment of skin vulnerability Reliability of assessment of scarring Difficulty establishing history of previous pressure ulcer: Difficult and time consuming Where information available was of poor quality (e.g. severity not clear) Duration of weight loss not specified Assessment of circulation items in patients with respiratory problems Analysis of movement difficult to categorize
Usability	Will be easy for nurses to remember and report red boxes at handover Step 1 screening is efficient in allowing the quick identification of those who do not require a full assessment Not having to visually inspect pressure areas when a patient was not at risk was appreciated	Local production difficult if no colour printers available