Minimum Data Set for Incontinence-Associated Dermatitis (MDS-IAD) in adults: Design and pilot study in nursing home residents

Publication date: Available online 25 October 2018

Source: Journal of Tissue Viability

Author(s): Karen Van den Bussche, Sofie Verhaeghe, Ann Van Hecke, Dimitri Beeckman

Abstract

Study aim

The aim of this study was to develop a Minimum Data Set for Incontinence-Associated Dermatitis (MDS-IAD), to psychometrically evaluate and pilot test the instrument in nursing homes. Comparable to the MDS for pressure ulcers, the MDS-IAD aims to collect epidemiological data and evaluate the quality of care.

Materials and methods

After designing and content/face validation by experts and clinicians, staff nurses assessed 108 residents (75.9% female, 77.8% double incontinent) in a convenience sample of five wards. A second nurse independently assessed fifteen residents to calculate inter-rater agreement (p₀) and reliability [Cohen's Kappa (ĸ)].

Results

The ĸ-value for 'urinary incontinence' was 0.68 [95% confidence interval (CI) 0.37–0.99] and 0.55 (95% CI 0.27–0.82) for 'faecal incontinence'. The p₀ for severity categorisation according to the Ghent Global IAD Categorisation Tool (GLOBIAD) was 0.60. IAD was diagnosed in 21.3% of the residents. IAD management mainly involved the application of a leave-on product (66.7%), no-rinse foams (49.1%), toilet paper (47.9%), and water and soap (38.8%). Fully adequate prevention or treatment was provided to respectively 3.6% and 8.7% of the residents.

Conclusion

This instrument provides valuable insights in IAD prevalence at organisational level, will allow benchmarking between organisations, and will support policy makers. Future testing in other healthcare settings is recommended.