Inter-rater and intra-rater reliability outcomes of a rapid bacteria counting system with pressure ulcer samples.
OBJECTIVE
Evaluating bacterial load in pressure ulcers (PUs) is key to combat infection; therefore, using technologies to measure bacterial count can be particularly useful. A rapid bacteria counting system was recently developed and introduced to the wound care field. However, its reliability was not established. This cross-sectional study aimed to evaluate the inter-rater and intra-rater reliability of bacterial count using this rapid counting system.


METHODS
We took bacterial swabs from patients with category I or greater PUs to assess inter- and intra-rater reliability. An assessor swabbed the longest axis of the PU once and bacterial counts were measured using a rapid bacteria counting system. To confirm the inter-rater and intra-rater reliability, intraclass correlation coefficients (ICCs) were calculated.


RESULTS
We took 63 and 57 pairs of bacterial counts from 13 patients with 16 category I or greater PUs to assess inter- and intra-rater reliability, respectively. Overall ICCs [95% confidence intervals (CI)] for the bacterial counts were 0.83 [0.73-0.90, p<0.001, inter-rater reliability, n=63], and 0.89 [0.82-0.94, p< 0.001, intra-rater reliability, n=57].


CONCLUSIONS
A high level of reliability for counting bacterial numbers in PU sites was confirmed. The results should encourage clinicians and researchers to use this type of device for the real-time assessment of wound bacterial bioburden at the patient's bedside.
Lecturer, Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
G
G
Nakagami
Head Nurse, Department of Nursing, The University of Tokyo Hospital, Tokyo, Japan.
M
M
Mori
Assistant Professor, Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
M
M
Yoshida
Graduate Student, Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
A
A
Kitamura
Clinical Fellow, Department of Plastic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
A
A
Hayashi
Lecturer, Department of Dermatology, The University of Tokyo Hospital, Tokyo, Japan.
T
T
Miyagaki
WOC Nurse, Department of Nursing, The University of Tokyo Hospital, Tokyo, Japan.
S
S
Sasaki
Professor, Advanced Health Care Science Research Unit, Innovative Integrated Bio-Research Core, Institute for Frontier Science Initiative, Kanazawa University, Ishikawa, Japan.
J
J
Sugama
Professor, Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
H
H
Sanada
D000368:Aged; D000369:Aged, 80 and over; D058491:Bacterial Load; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D003668:Pressure Ulcer / Q000382:microbiology*; D015203:Reproducibility of Results; D014946:Wound Infection / Q000175:diagnosis*
bacterial bioburden; intra-class correlation coefficient; wound assessment; wound healing