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J Nurs Care Qual. 2006 Jul-Sep;21(3):256-65.

Reliability testing of the National Database of Nursing Quality Indicators pressure ulcer indicator.

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University of Kansas School of Nursing, Kansas City, Kan, USA.


A criterion-referenced Web-based test was designed and administered to 256 individuals at 48 randomly sampled National Database of Nursing Quality Indicators (NDNQI) member hospitals to determine the reliability of the NDNQI pressure ulcer indicator. Overall kappa values for pressure ulcer identification, staging, and sourcing indicate moderate to near perfect reliability. Findings suggest that nurses can accurately differentiate pressure ulcers from other ulcerous wounds in Web-based photographs, reliably stage pressure ulcers, and reliably identify community versus nosocomial pressure ulcers.

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