{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T14:26:19Z","timestamp":1790778379200,"version":"4.1.0"},"reference-count":78,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Signs of clinical deterioration may appear differently in children with dark\u2010coloured skin. How to assess children in this cohort is currently poorly defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To explore available information on the assessment of clinical deterioration in children with dark\u2010coloured skin and identify research deficits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A scoping review following Arksey and O'Malley and PRISMA\u2010ScR frameworks. Five online databases, grey literature and reference lists of eligible documents were searched. Source titles, abstracts and full texts were screened. Included documents were assessed for level of evidence according to the Joanna Briggs Institute. Data were charted on a pre\u2010defined data collection tool and analysed through descriptive and content analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Out of 2382 documents screened, 37 were included. Document types included 16 quantitative studies, 14 opinion papers, five reviews and two reports. Most sources (21) were low\u2010level evidence. Sixty\u2010six unique terms were used to describe dark\u2010coloured skin. Eighteen documents reported use of a skin classification system, including race\/ethnicity, established colour scales, cosmetic references and observer opinion. Twelve focused on newborn hyperbilirubinaemia. Considerations for assessing jaundice, pallor, cyanosis, pulse oximetry, petechiae and signs of shock were reported. Techniques to improve assessment included optimising the environment, identifying baseline skin colour, and involving families and patients in assessment. No documents reported on assessment of mottling or capillary refill time for children with dark\u2010coloured skin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Linking Evidence to Action<\/jats:title>\n                    <jats:p>Assessment of clinical deterioration for children with dark\u2010coloured skin is highly relevant to health professional practice. There is an overall deficit in high\u2010quality research. Specific information gaps in assessment are considerations for mottling, capillary refill time, APGAR scoring, and clinical implications of device overestimation of bilirubin and oxygen saturations in children with dark\u2010coloured skin. Health professionals are encouraged to use devices cautiously. Greater accuracy and objectivity are necessary to fill these gaps and support effective detection of signs of clinical deterioration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocn.70060","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T11:51:26Z","timestamp":1755085886000},"page":"513-523","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Assessing Clinical Deterioration in Children With Dark\u2010Coloured Skin: A Scoping Review"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5717-0658","authenticated-orcid":false,"given":"Chelsea","family":"Kelly","sequence":"first","affiliation":[{"name":"School of Nursing, Curtin University  Bentley Western Australia Australia"},{"name":"Perth Children's Hospital, Child and Adolescent Health Service  Nedlands Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavin D.","family":"Leslie","sequence":"additional","affiliation":[{"name":"School of Nursing, Curtin University  Bentley Western Australia Australia"},{"name":"Fiona Stanley Hospital, South Metropolitan Health Service  Murdoch Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Laird","sequence":"additional","affiliation":[{"name":"School of Nursing, Curtin University  Bentley Western Australia Australia"},{"name":"Perth Children's Hospital, Child and Adolescent Health Service  Nedlands Western Australia Australia"},{"name":"Wal\u2010yan Respiratory Research Centre, The Kids Research Institute, University of Western Australia, Perth Children's Hospital  Nedlands Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Stokes","sequence":"additional","affiliation":[{"name":"School of Nursing, Curtin University  Bentley Western Australia Australia"},{"name":"Kimberley Regional Paediatric Services, Broome Hospital, WA Country Health Service  Broome Western Australia Australia"},{"name":"National School of Nursing and Midwifery, University of Notre Dame Australia, Broome Campus  Broome Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fenella J.","family":"Gill","sequence":"additional","affiliation":[{"name":"School of Nursing, Curtin University  Bentley Western Australia Australia"},{"name":"Perth Children's Hospital, Child and Adolescent Health Service  Nedlands Western Australia Australia"},{"name":"Fiona Stanley Hospital, South Metropolitan Health Service  Murdoch Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,13]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2014.05.009"},{"key":"e_1_2_11_3_1","unstructured":"Aginga C.2021.\u201cSkin Assessment: Ethnic Diversity [Evidence Summary].\u201dThe JBI EBP Database. 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