Braden Scales for Pressure Injury Risk Assessment

Delmore, Barbara; Ayello, Elizabeth A.

doi:10.1097/01.asw.0000931808.23779.44

Cited by 2 publications

(3 citation statements)

References 36 publications

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Section: Introductionmentioning

confidence: 99%

“…These factors have led to a large body of literature focusing on the application of techniques for the estimation of PU risk, such as risk assessment scales [9,10] or data science approaches [11][12][13]. For instance, the Norton scale [14] consists of five parameters (physical condition, mental state, activity, mobility, and incontinence), while the Braden scale [9], the most widely used tool in clinical practice, considers six factors (sensory perception, moisture, activity, mobility, nutrition, and friction/shear). Other examples include the COMHON index [15], designed for intensive care, consisting of five items (conscious level, mobility, hemodynamics, oxygenation, and nutrition) and the CALCULATE scale [10], which consists of a total of eight items (too unstable to turn, impaired circulation, dialysis, mechanical ventilation, long surgery, low protein, fecal incontinence, and immobility).…”

Section: Introductionmentioning

confidence: 99%

“…Following the recommendations of risk levels of PUs provided by GNEAUPP [24], the risk level for each patient was determined using the Braden scale [9]: patients with a score of 19 or more are labeled as no risk, patients with a score between 15 and 18 as mild risk, patients with a score between 13 and 14 as moderate risk, and, finally, patients with a score of 12 or less are labeled as high risk. A descriptive analysis of the input indicators (skin moisture, activity, and mobility) and the output class (pressure ulcer risk) is shown in Table 1.…”

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confidence: 99%

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Differentiating Pressure Ulcer Risk Levels through Interpretable Classification Models Based on Readily Measurable Indicators

Vera-Salmerón,

Domínguez-Nogueira,

Sáez

et al. 2024

Healthcare

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Pressure ulcers carry a significant risk in clinical practice. This paper proposes a practical and interpretable approach to estimate the risk levels of pressure ulcers using decision tree models. In order to address the common problem of imbalanced learning in nursing classification datasets, various oversampling configurations are analyzed to improve the data quality prior to modeling. The decision trees built are based on three easily identifiable and clinically relevant pressure ulcer risk indicators: mobility, activity, and skin moisture. Additionally, this research introduces a novel tabular visualization method to enhance the usability of the decision trees in clinical practice. Thus, the primary aim of this approach is to provide nursing professionals with valuable insights for assessing the potential risk levels of pressure ulcers, which could support their decision-making and allow, for example, the application of suitable preventive measures tailored to each patient’s requirements. The interpretability of the models proposed and their performance, evaluated through stratified cross-validation, make them a helpful tool for nursing care in estimating the pressure ulcer risk level.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Differentiating Pressure Ulcer Risk Levels through Interpretable Classification Models Based on Readily Measurable Indicators

Vera-Salmerón,

Domínguez-Nogueira,

Sáez

et al. 2024

Healthcare

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Pressure injury risk assessment and prescription of preventative interventions using a structured tool versus clinical judgement: An interrater agreement study

Fulbrook,

Lovegrove,

Ven

et al. 2024

Journal of Advanced Nursing

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AimTo assess agreement of pressure injury risk level and differences in preventative intervention prescription between nurses using a structured risk assessment tool compared with clinical judgement.DesignInterrater agreement study.MethodsData were collected from November 2019 to December 2022. Paired nurse‐assessors were allocated randomly to independently assess pressure injury risk using a structured tool (incorporating the Waterlow Score), or clinical judgement; then prescribe preventative interventions. Assessments were conducted on 150 acute patient participants in a general tertiary hospital. Agreement of risk level was analysed using absolute agreement proportions, weighted kappa and prevalence‐adjusted and bias‐adjusted kappa.ResultsNinety‐four nurse assessors participated. Absolute agreement of not‐at‐risk versus at‐risk‐any‐level was substantial, but absolute agreement of risk‐level was only fair. Clinical judgement assessors tended to underestimate risk. Where risk level was agreed, prescribed intervention frequencies were similar, although structured tool assessors prescribed more interventions mandated by standard care, while clinical judgement assessors prescribed more additional/optional interventions. Structured tool assessors prescribed more interventions targeted at lower‐risk patients, whereas assessors using clinical judgement prescribed more interventions targeted at higher‐risk patients.ConclusionThere were clear differences in pressure injury risk‐level assessment between nurses using the two methods, with important differences in intervention prescription frequencies found. Further research is required into the use of both structured tools and clinical judgement to assess pressure injury risk, with emphasis on the impact of risk assessments on subsequent preventative intervention implementation.ImpactThe results of this study are important for clinical practice as they demonstrate the influence of using a structured pressure injury risk assessment tool compared to clinical judgement. Whilst further research is required into the use of both structured tools and clinical judgement to assess pressure injury risk and prescribe interventions, our findings do not support a change in practice that would exclude the use of a structured pressure injury risk assessment tool.Reporting MethodThis study adhered to the GRRAS reporting guideline.Patient/Public ContributionNo patient or public involvement in this study.Implications for the profession and/or patient careEducators and researchers can use the findings to guide teaching about pressure injury risk assessment and preventative intervention and to direct future studies. For clinical nurses and patients, a change in clinical practice that would exclude the use of a structured risk assessment tool is not recommended and further work is needed to validate the role of clinical judgement to assess risk and its impact on preventative intervention.

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Braden Scales for Pressure Injury Risk Assessment

Cited by 2 publications

References 36 publications

Differentiating Pressure Ulcer Risk Levels through Interpretable Classification Models Based on Readily Measurable Indicators

Differentiating Pressure Ulcer Risk Levels through Interpretable Classification Models Based on Readily Measurable Indicators

Pressure injury risk assessment and prescription of preventative interventions using a structured tool versus clinical judgement: An interrater agreement study

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