Predicting pressure ulcer risk: a study of the predictive validity of the Braden scale at different health care settings
Samah Saad Salem Mohamed
Medical Surgical Nursing Dept., Faculty of Nursing, Cairo University, Cairo, Egypt.
Nursing Dept., Alfarabi Colleges, Riyadh, Kingdom of Saudi Arabia.
Abstract: Pressure ulcers are serious problems that occur frequently in acute and long term facilities. Once they occur, pressure ulcers may lead to sepsis and death. A key to prevention is early detection of at-risk patients with a valid and reliable pressure ulcer risk assessment instrument. The Braden scale is one of the most intensively used tools designed to facilitate that assessment. The Braden scale consists of six subscales that evaluate a patient's sensory perception, activity level, mobility, and nutrition status and the skin's exposure to moisture, friction and shear forces. Therefore, the aim of the study is to identify the predictive validity of the Braden scale at different health care settings. A total of 100 male and female patients, older than 19 years, from a variety of health care settings orthopedic, neurologic-emergency, and intensive care units, who don't have pressure ulcers, admitted within the previous 72 hours, have anticipated hospital stay period at least 1 week were assessed. A descriptive correlational research design was utilized. Questionnaires filled by the researcher were: Socio-demographical and biomedical data sheet and Braden scale for predicting pressure ulcer risk. Observations were made every 48 to 72 hours for a minimum of 1 to a maximum of 4 weeks. The outcome (presence/absence and stage of pressure ulcer) was documented at each assessment. 29% of subjects developed pressure ulcers. The incidence was 15% for stage I, and 14% for stage II, the Braden scale showed a 66.7% sensitivity,100% specificity, 66.7% predictive value of positive test and predictive value of negative test was 96.3%, and the cut- off point for classifying the pressure ulcer risk was 18, with overall accuracy 92.5%. The study recommended using the Braden scale but, for generalization, we need to test the tool's specificity and sensitivity at multi-center and for at least 1000 patients from different population to test the predictive validity of the Braden scale.
[Samah Saad Salem Mohamed. Predicting pressure ulcer risk: a study of the predictive validity of the Braden scale at different health care settings. J Am Sci 2013;9(6):515-523]. (ISSN:1545-1003).http://www.jofamericanscience.org. 64
Key words: pressure ulcer, Braden scale, predictive validity, specificity, sensitivity. Full Text 64