Damage control

H Y W A R D S / S H U T T E R S TO C K Skin injuries such as incontinence-associated dermatitis (IAD) and pressure injuries are increasingly monitored and benchmarked as a quality indicator for hospitals and nursing facilities.1-4 Pressure injuries are documented by Medicare and Medicaid-certified skilled nursing facilities in the Minimum Data Set, and pressure injury incidence rates are publicly reported as a quality measure in the Nursing Home Compare website.5 Many clinicians have difficulty distinguishing superficial skin injuries from early-stage pressure injuries because the differences can be very subtle. Mistaking IAD for an early-stage pressure injury can result in ineffective treatment and possible deterioration to full-thickness injury.6,7 This is particularly true in patients with dark skin tones because visual cues associated with these types of skin injuries may