Issues Related to Accurate Classification of Buttocks Wounds : Journal of Wound Ostomy & Continence Nursing (original) (raw)
WOUND CARE
Mary Mahoney, BSN, RN, CWON, Iowa Health Home Care, Urbandale, Iowa.
Barbara Rozenboom, BSN, RN, CWON, Iowa Health Home Care, Urbandale, Iowa.
Dorothy Doughty, MN, RN, CWONCN, FAAN, Emory University WOC Nursing Education Program, Emory University WOC Nursing Education Center, Atlanta, Georgia.
Hayden Smith, MS, MPH, Medical Education Services, Iowa Methodist Medical Center, Des Moines.
Correspondence: Dorothy Doughty, MN, RN, CWOCN, FAAN, Emory University WOC Nursing Education Program, Emory University WOC Nursing Education Center, 1365 Clifton Rd, NE Atlanta, GA 30322 ([email protected]).
The authors declare no conflict of interest.
Abstract
PURPOSE:
This study was designed to determine the level of agreement among wound care nurses when asked to classify the etiology of 9 wounds located on the buttocks and within the intergluteal cleft.
SUBJECTS:
Study subjects were 100 wound care nurses who responded to an invitation placed on the WOCN Society's wound care forum and to an e-mail sent to members of the WOCN Iowa Affiliate.
METHODS:
Respondents were asked to view 9 unique wound photos and to determine whether the primary etiologic factor was pressure, moisture, incontinence-associated dermatitis, or skin tear. Subjects were given no background information regarding the patients but were allowed to add comments.
RESULTS:
The overall κ analysis of the 9 photos combined was 0.1708 (99% confidence interval, 0.1630-0.1786). The testing of the overall κ for the 9 photos equaling “0” or mere chance produced a P < .0001. Analyses revealed that the agreement between the 100 respondents for the 9 photos was only 17% better than chance alone. In summary, our study revealed only “Slight Agreement” between wound care nurses' classifications of photo subgroups or for all 9 photos analyzed together.
IMPLICATIONS:
Accurate wound classification impacts not only treatment decisions but also reimbursement, risk of litigation, and accuracy of data regarding prevalence and incidence of pressure ulcers. It is, therefore, critical for professional societies such as the WOCN to begin development of consensus definitions and guidelines to ensure consistency and accuracy in wound classification.
Copyright © 2011 by the Wound, Ostomy and Continence Nurses Society