التفاصيل البيبلوغرافية
| العنوان: |
Assessment and documentation of incontinence-associated dermatitis after implementation of a standardised instrument: a comparative study. |
| المؤلفون: |
Montague, Mary, Karafa, Matthew, Albert, Nancy M. |
| المصدر: |
Journal of Wound Care; 2019 Supplement 9, Vol. 28 Issue Sup9, pS4-S11, 8p, 3 Charts, 1 Graph |
| مصطلحات موضوعية: |
COMPARATIVE studies, CONFIDENCE intervals, STATISTICAL correlation, DEFIBRILLATORS, DOCUMENTATION, EXPERTISE, FISHER exact test, HOSPITAL wards, LONGITUDINAL method, RESEARCH methodology, NURSES, STATISTICAL sampling, SKIN inflammation, STATISTICS, TRAUMATOLOGY diagnosis, WOUND care, HUMAN services programs, INTER-observer reliability, SEVERITY of illness index, DATA analysis software, ELECTRONIC health records, DESCRIPTIVE statistics, ODDS ratio, ONE-way analysis of variance |
| مستخلص: |
Objective: In this study, clinical nurses' documentation of incontinence-associated dermatitis (IAD) were compared with wound expert documentation before and after implementing a valid, reliable severity index (SI) instrument. Methods: A prospective, non-equivalent, two group comparative design within three hospital medical units. Pre- and post-implementation skin condition documentation were compared by clinician type, and post-implementation IADSI scores were assessed for agreement using standard and weighted Kappa. Results: Of 89 patients (pre-, n=48 and post-, n=38), mean (standard deviation) age was 72.4±13.7 years and 57.3% had IAD. Mean IADSI score was 13.2 (standard deviation: 10.5; range: 0–52), reflecting pink intact skin. Post-implementation, skin documentation between clinicians was more likely to match, from 35.4 to 84.2%, p<0.001. Post-implementation, after controlling for age, gender and race, the odds ration (OR) of matched documentation between clinicians was 5.80 ([95% confidence interval: 1.8, 18.6], p=0.003) compared with pre-implementation. In the post-implementation period, standard Kappas for agreement in clinical nurse-wound expert documentation in the lower back/buttocks/upper thigh areas ranged from 0.82 to 1.0, reflecting very good agreement. Weighted kappas ranged from 0.76 to 1.0, also reflecting good to very good agreement. Conclusion: Implementation of an IADSI assessment instrument improved accuracy of IAD documentation. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
