Abstract: Validity and Reliability of Updated Incontinence Associated Skin Damage Instrument.D2 for Light to Dark Skin after Feedback from WOC Nurses (47th Annual Conference (June 6

Tuesday, June 9, 2015: 4:30 PM

Donna Z. Bliss, PhD, RN, FAAN, FGSA¹, Jenny Hurlow, MSN, GNP-BC, CWOCN², Jean E. Cefalu, MSN, APRN, CWOCN, CFCN³, Kathleen Borchert, MS, RN, ACNS-BC, CWOCN⁴, Leigh Mahlum, BA⁵ and Kjerstie R. Wiltzen, BA, BSN, RN⁵, (1)Nursing, University of Minnesota School of Nursing, Minneapolis, MN, (2)Plastic Surgery Group of Memphis, APN, Memphis, TN, (3)School of Nursing, LSUHSC, New Orleans, LA, (4)Provider, HealthEast Bethesda Hospital, St. Paul, MN, (5)School of Nursing, University of Minnesota, Minneapolis, MN

Background: The Incontinence Associated Dermatitis and its Severity.D2 Instrument, now called the Incontinence Associated Skin Damage.D2 Instrument (IASD.D2), was developed and validated for use with light to dark toned skin. WOC nurses offered feedback at previous testing to refine the instrument and revise its name to promote use by all nursing staff.

Purpose: To develop and test an updated IASD.D2 instrument for assessing IAD using photographs of light to dark toned skin among WOC nurses

Method: Investigator and two certified WOC nurse consultants updated the IASD.D2 instrument by describing the boundaries of body areas of IAD cited on the tool, adding a contralateral body area to score to improve monitoring resolution of IAD, and adjusting the numbering of body areas of IAD. Nine photographic cases with and without IAD were tested: 2 cases with light, 3 with medium and 4 with dark skin tone. Agreement of IASD.D2 scores between raters and experts+investigators and among raters was determined using intraclass correlations (ICCs). IASD.D2 scores were compared by self-reported skin tone of raters using ANOVA: 78% raters had light, 21% medium, and 2% dark toned skin.

Results: 200 nurse attendees at 2014 WOCN Society National Conference (96.5% female, mean(sd) age=53(8) years, WOC experience=13(9) years) completed the testing. Average ICC between raters and experts overall for all cases = 0.993 (p<.001). Average ICC for raters’ vs. experts’ scores for each case ranged from 0.97-.1.0 (all p<.001). Average ICC among WOC nurse raters for each case = 0.92-1.0 (all p<.001). There was no significant difference in IASD.D2 scores by raters’ skin tone (p>.05).

Conclusion: The updated IASD.D2 instrument has very good validity among WOC nurses and was not influenced by rater skin tone. Timely recognition and systematic monitoring of IASD may facilitate its management and prevent worsening.

CT15-003 Validity and Reliability of Updated Incontinence Associated Skin Damage Instrument.D2 for Light to Dark Skin after Feedback from WOC Nurses