Moisture-Associated Skin Damage – What is it?
Moisture-Associated Skin Damage (MASD) is the result of prolonged exposure to the skin from moisture which comes from various sources of bodily fluids, primarily:
- urinary and faecal incontinence
- wound exudate
This causes a varying degree of excoriation which can prove to be debilitating for individuals.
What was the initiative behind S.M.A.R.T.?
S.M.A.R.T. resource was developed following an update from NHS Improvement (now merged with NHS England) in June 2018, highlighting that all Primary and Secondary care organisations should identify and report Moisture-Associated Skin Damage (MASD) at a National level.
It was evident at the time of this announcement that there was no generic or nationally recognised reporting system for MASD, hence a decision to develop an easy-to-follow resource that can be used to categorise and report MASD. Healthcare Practitioners have long felt that there were problems in recognising the signs of MASD when caring for individuals who may also be at risk of pressure ulcers; therefore we wanted to develop something user-friendly which could be used to easily identify causes of MASD and provide advice on subsequent treatment.
The initial concept was to be in keeping with the educational offerings from Medicareplus International. This being a description of “Mild”, “Moderate” and “Severe” moisture damage. As it had already been ascertained that there was no nationally recognised classification, the aim was to keep the resource generic without specific product guidance, allowing it to be utilised nationally by a wide range of healthcare practitioners.
By utilising a classification resource like S.M.A.R.T., it would ensure that appropriate treatment could be given to patients, and through correct management, ensure a cost effective outcome to benefit patient experience.
How successful is S.M.A.R.T.?
S.M.A.R.T. was initially launched at Wounds UK in Harrogate in November 2019 with overwhelming success. We were approached by Tissue Viability Specialists from across the UK who were interested in implementing the resource into their Trusts.
Since then, the resource has been adopted widely across numerous Acute and Community Trusts, many of which have downloaded the resource to their Trust’s intranet site. We are still auditing MASD incidence figures with Trusts.
Alongside the online/downloadable resource, we have produced a pocket-sized laminated card that staff can carry with them on the wards and in the community for quick reference whilst assessing patients.
However, the highlight of the development of S.M.A.R.T. is, that the resource has been Nationally recognised and in January 2020 received a statement of endorsement from NICE to further support their Clinical and Nursing guidelines on:
- Pressure ulcers Prevention and Management (CG 179)
- Urinary incontinence and pelvic floor organ prolapse in women: Management (NG 123)
- Faecal incontinence in adults: Management (CG 49)
This was a defining moment for S.M.A.R.T. as it is the only MASD reporting resource nationally endorsed by NICE.
We were also fortunate to have developed a poster around S.M.A.R.T. that was accepted for presentation at Wounds UK and at Wound Care Today 2020.
What’s next for S.M.A.R.T.?
We are continuing to work with Tissue Viability Specialists in further validating S.M.A.R.T. in a variety of clinical settings. S.M.A.R.T. has been further developed to offer a complete education package around its use.
To find out more about S.M.A.R.T. and how it can help in your clinical setting or to get involved in further validation of S.M.A.R.T., please contact: firstname.lastname@example.org
Download the S.M.A.R.T. Resource here: https://medicareplus.co.uk/masd-categorisation-tool/
Request your S.M.A.R.T. Card here: https://medicareplus.co.uk/smartcard/
Claire Winterbottom, Clinical Nurse Advisor, Medicareplus International Ltd.