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Incontinence-Associated Dermatitis and Intertriginous Dermatitis as Nurse-Sensitive Quality Indicators: A Delphi Study

Arnold-Long, Mary; Emmons, Kevin; Chovan, John, D.

Journal of Wound, Ostomy and Continence Nursing: May/June 2018 - Volume 45 - Issue 3 - p 221–226
doi: 10.1097/WON.0000000000000427
Wound Care

PURPOSE: This purpose of this study was to determine whether consensus exists concerning the need to collect epidemiologic data about 2 forms of moisture-associated skin damage, incontinence-associated dermatitis (IAD) and intertriginous dermatitis (ITD), and whether these data should be part of data routinely collected as part of the National Database of Nursing Quality Indicators (NDNQI).

DESIGN: Modified Delphi technique.

SAMPLE AND SETTING: Questionnaires were sent via e-mail to 50 identified experts, with an initial response of 17. Thirteen clinical experts responded to the second round and 11 responded to a third round.

METHODS: Items on the questionnaires were investigator-developed. Consensus was defined as 80% or more agreement. Three rounds of questionnaires were employed to attempt consensus. Descriptive statistics were performed using mean and standard deviation for continuous data and frequencies and percentages for categorical data. Qualitative data were analyzed question by question by the primary researcher using content analysis.

RESULTS: Consensus was achieved indicating that individual facilities should regularly collect data about IAD prevalence or incidence. Consensus was not reached about the need to regularly collect data about ITD prevalence or incidence. Panelists also failed to reach consensus that IAD or ITD prevalence or incidence should be incorporated into the NDNQI indicators.

CONCLUSION: Panelists did not reach consensus that IAD or ITD epidemiologic data should be incorporated on the NDNQI. Additional research is needed, particularly in the area of ITD, before benchmarks can be established regarding these data as nurse-sensitive indicators of quality care.

Mary Arnold-Long, DNP, APRN, CRRN, CWOCN-AP, ACNS-BC, Roper Hospital, Charleston, South Carolina.

Kevin Emmons, DrNP, APN, AGPCNP-BC, CWCN, Rutgers Camden University, Camden, New Jersey.

John D. Chovan, PhD, DNP, RN, CNP, CNS, PMHNP-BC, PMHCNS-BC/Adult, ACHPN, Otterbein University, Westerville, Ohio.

Correspondence: Mary Arnold-Long, DNP, APRN, CRRN, CWOCN-AP, ACNS-BC, Roper Hospital, 316 Calhoun St, Charleston, SC 29401 (

The authors declare no conflicts of interest.

© 2018 by the Wound, Ostomy and Continence Nurses Society.