Date Written


Document Type






First Committee Member


Second Committee Member



Moisture Associated Skin Damage, MASD, Incontinence Associated Dermatitis, IAD, Intertriginous Dermatitis, ITD, Intertrigo, Pressure Ulcer

Subject Categories

Medicine and Health Sciences | Nursing | Other Nursing


Pressure ulcer (PU) data are collected by hospitals and reported quarterly as a nursing sensitive quality indicator via the National Database of Nursing Quality Indicators (NDNQI). Incontinence-associated dermatitis (IAD) and gluteal intertriginous dermatitis (ITD), both forms of moisture associated skin damage (MASD), are caused by moisture, not pressure or shear. These two forms of skin damage may be mistaken for PUs and may be reported in error as PUs. If the assessment of the skin damage is incorrect, the reporting is incorrect and the NDNQI database is incorrect. If the NDNQI database is incorrect then practice and policy regarding identification, treatment, patient outcomes, and associated health care costs are incorrect. The question becomes how to correct this. The purpose of this clinical project was to build expert consensus on whether or not IAD and/or ITD should be reported as nursing sensitive outcomes and whether or not they should be included in the NDNQI.

A modified Delphi Survey of nursing experts published on IAD and/or ITD was used to build consensus regarding whether IAD and/or ITD should be included as NDNQI quality outcomes. An electronic instrumentation, distribution, and data collection tool was sent via email to a purposeful sample of fifty nursing experts nominated by the editor of the Journal of Wound Ostomy Continence Nursing (JWOCN) and director of the Wound, Ostomy, and Continence Nurses Society Center for Clinical Investigation (CCI).

Following three rounds of questionnaires, consensus was reached that data should be collected on both IAD incidence and prevalence and ITD incidence and prevalence. The international experts agreed, however, that including them in the NDNQI is premature and that the data collection should begin with the aim of facility-specific quality improvement first.

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