Pressure ulcer risk assessment: retrospective analysis of Braden Scale scores in Portuguese hospitalised adult patients

AbstractWhen conducting prevalence surveys pressure ulcers were found in participants clearly identified not to be at risk. This article determines and analyses persons in German hospitals and nursing homes who suffer from pressure ulcers but are not at risk. In the years 2002, 2003 and 2004 there were 7,097 nursing home residents and 23,966 hospital patients examined in annual pressure ulcer prevalence surveys. A risk assessment according to the Braden Scale was performed for each participant on the day of the survey. “Not at risk” participants were defined by Braden score cut-off > 20 points. There were 440 of 3,012 (14.6%) persons with pressure ulcer who were considered not to be at risk. In hospitals, 16.1% of all patients with pressure ulcers were not at risk, in nursing homes it was 8.2%. A high variance between medical specialties and individual institutions was found in the number of those not at risk but with pressure ulcer. In the group not at risk, persons with and without a pressure ulcer differed regarding activity and friction and shear in nursing homes. In hospitals those persons differed regarding age and all single items of the Braden scale apart from sensory perception. Pressure ulcers that are more severe, located at the hip or lower back or the origin of which is unknown are more likely to be considered to be at risk by the Braden risk assessment tool.The results may indicate insufficient abilities of the Braden scale for certain kind of pressure ulcer wounds.

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Enhancement of Decision Rules to Increase Generalizability and Performance of the Rule-Based System Assessing Risk for Pressure Ulcer

Applied Clinical Informatics ◽

10.4338/aci-2012-12-ra-0056 ◽

2013 ◽

Vol 04 (02) ◽

pp. 251-266 ◽

Cited By ~ 2

Author(s):

H. Kim ◽

J. Choi

Keyword(s):

Risk Assessment ◽

Pressure Ulcer ◽

Assessment Tool ◽

Decision Rules ◽

Survey Study ◽

Rule Based ◽

Rule Based System ◽

Braden Scale ◽

And Performance ◽

Level Of Agreement

SummaryBackground: A rule-based system, the Braden Scale based Automated Risk Assessment Tool (BART), was developed to assess risk for pressure ulcer in a previous study. However, the BART illustrated two major areas in need of improvement, which were: 1) the enhancement of decision rules and 2) validation of generalizability to increase performance of BART.Objectives: To enhance decision rules and validate generalizability of the enhanced BART.Method: Two layers of decision rule enhancement were performed: 1) finding additional data items with the experts and 2) validating logics of decision rules utilizing a guideline modeling language. To refine the decision rules of the BART further, a survey study was conducted to ascertain the operational level of patient status description of the Braden Scale.The enhanced BART (BART2) was designed to assess levels of pressure ulcer risk of patients (N = 99) whose data were collected by the nurses. The patients’ level of pressure ulcer risk was assessed by the nurses using a Braden Scale, by an expert using a Braden Scale, and by the automatic BART2 electronic risk assessment. SPSS statistical software version 20 (IBM, 2011) was used to test the agreement between the three different risk assessments performed on each patient.Results: The level of agreement between the BART2 and the expert pressure ulcer assessments was “very good (0.83)”. The sensitivity and the specificity of the BART2 were 86.8% and 90.3% respectively.Conclusion: This study illustrated successful enhancement of decision rules and increased general-izability and performance of the BART2. Although the BART2 showed a “very good” level of agreement (kappa = 0.83) with an expert, the data reveal a need to improve the moisture parameter of the Braden Scale. Once the moisture parameter has been improved, BART2 will improve the quality of care, while accurately identifying the patients at risk for pressure ulcers.Citation: Choi J, Kim H. Enhancement of Decision Rules to Increase Generalizability and Performance of the Rule-Based System Assessing Risk for Pressure Ulcer. Appl Clin Inf 2013; 4: 251–266http://dx.doi.org/10.4338/ACI-2012-12-RA-0056

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Use of the Braden Scale for Pressure Ulcer Risk Assessment in a Community Hospital Setting

Journal of Wound Ostomy and Continence Nursing ◽

10.1097/won.0000000000000066 ◽

2014 ◽

Vol 41 (6) ◽

pp. 535-538 ◽

Cited By ~ 7

Author(s):

Molly M. Gadd ◽

Sarah M. Morris

Keyword(s):

Risk Assessment ◽

Pressure Ulcer ◽

Community Hospital ◽

Hospital Setting ◽

Braden Scale

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Assessment of Pressure Injuries Following Surgery: A Descriptive Study

Wound Management & Prevention ◽

10.25270/wmp.2021.6.2740 ◽

2021 ◽

Vol 67 (6) ◽

pp. 27-40

Author(s):

Emel Yılmaz ◽

Arzu Başlı

Keyword(s):

Risk Assessment ◽

Scale Score ◽

Operation Time ◽

Descriptive Study ◽

Assessment Scale ◽

Lithotomy Position ◽

Braden Scale ◽

Scale Scores ◽

Pressure Injury ◽

The Mean

BACKGROUND: Pressure injury is a common problem for patients undergoing surgery and is a significant quality indicator for perioperative care. PURPOSE: To determine the rate of intraoperative pressure injuries and evaluate risk factors in surgical patients. METHODS: A descriptive study was conducted from May to December 2019 among consecutive patients older than 18 years of age undergoing a nonemergent (planned) surgical procedure lasting longer than 2 hours in a hospital in Turkey. Patients with a history of preoperative pressure injury were not eligible for participation. Data collected included demographic and clinical information, preoperative Braden Scale scores, and 3S Intraoperative Risk Assessment Scale scores. The presence of a pressure injury was evaluated immediately postoperatively and 24 hours postoperatively. Descriptive statistics, chi-square, Student t test, Mann-Whitney U test, one-way analysis of variance, and the Kruskal-Wallis test were used for postoperative skin integrity and factors affecting the risk of pressure injury in the intraoperative period. RESULTS: The 164 participants ranged in age from 18 to 80 years (mean, 51.58 ± 15.96 years). The most common procedures were orthopedic (47, 28.7%), the mean Braden Scale score was 19.96 ± 1.81, and the mean 3S Intraoperative Risk Assessment Scale score was 17.92 ± 3.03. Immediately postoperatively, 64.0% of patients had blanchable erythema and 6.7% had a stage 1 pressure injury. Also immediately postoperatively, noblanchable erythema was found to be affected by comorbidities, long hospitalization time before surgery, long operation time, American Society of Anesthesiologists score of II, lithotomy position, low body temperature, hypotension during surgery, and wetness under the gluteal and sacral area during surgery. In the skin assessment conducted 24 hours after surgery, 4.9% of patients had blanchable erythema. CONCLUSIONS: The majority of patients (95.1%) did not show signs of a pressure injury during the time of the study (24 hours). Additional and longer-term studies are warranted.

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Braden Scale in pressure ulcer risk assessment

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2019-0413 ◽

2020 ◽

Vol 73 (6) ◽

Author(s):

Ricardo Clayton Silva Jansen ◽

Kedyma Batista de Almeida Silva ◽

Maria Edileuza Soares Moura

Keyword(s):

Risk Assessment ◽

Intensive Care Unit ◽

Pressure Ulcer ◽

Assessment Instrument ◽

Cross Sectional ◽

Risk Assessment Instrument ◽

Physical Mobility ◽

Nursing Diagnosis ◽

Braden Scale ◽

Predictive Risk

ABSTRACT Objective: To analyze the applicability of the Braden Scale to individuals admitted to an Intensive Care Unit (ICU) with the nursing diagnosis Impaired Physical Mobility, in its prediction potential to develop pressure ulcer (PU). Methods: A cross-sectional, quantitative study that evaluated all patients hospitalized in an ICU between November 2016 and February 2017, with the Braden Scale. Results: The prevalence of PU was 35.8% (24/67), in male individuals 58.3% (14/24), diagnosed with ischemic CVA 51.9% (12/27), and with hemorrhagic CVA 7.4% (2/27). Among patients classified at severe risk of developing pressure ulcer, 83.3% (20/53) developed it, and 76.7% (33/53) did not develop it. Conclusion: The performance of the Braden Scale showed a balance between sensitivity and specificity, confirming it as a better predictive risk assessment instrument in this group of patients.

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