Braden Scale in pressure ulcer risk assessment

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.

Descriptors:
Comprehensive Health cCare; Critical Care; Nursing Care; Nursing Assessment; Nursing Diagnosis

Variables	Developed PU		No Developed PU		p value*
Variables	n = 24		n = 43		p value*
Gender					0,456
Male	14	58.3	21	48.8
Female	10	41.7	22	51.2
Age	76.5 (60-100)		65.0 (19-96)		0.001
Length of stay	8 (4-33)		3 (2-10)		< 0.001
Color					0.650
White	5	20.8	12	27.9
Black	7	29.2	11	25.6
Parda (brown)	10	41.7	19	44.2
Yellow (Asian descended)	2	8.3	1	2.3
Reason for hospitalization					0.134
Respiratory	4	16.7	9	23.1
Cardiovascular	18	75.0	20	51.3
Metabolic	2	8.3	10	25.6
Medication					0.347
hypoglycemic agent	10	41.7	12	27.9
Antipsychotic	9	37.5	24	55.8
Anticonvulsants	5	20.8	7	16.3
Nursing diagnosis					0.401
Impaired ability to reposition in bed	4	16.7	11	25.6
Impaired ability to move from side to side	20	83.3	32	74.4

	Developed PU		Did not develop PU		p value
	n	%	n	%	p value
Braden scale					0.675
Moderate risk	0	0.0	1	2.3
High Risk	4	16.7	9	20.9
Severe risk	20	83.3	33	76.7

Medical diagnosis	Sim LPP		Não LPP		OR	IC 95%
Medical diagnosis	n	%	n	%	OR	IC 95%
CVA-I	14	58.3	14	32.6	6.75	1.86-24.41
Pneumonia	3	12.5	6	13.9	3.38	0.59-19.21
CVA-H	2	8.3	2	4.7	6.75	0.73-62.37
Acute respiratory distress	2	8.3	5	11.6	2.7	0.38-18.92
Cirrhosis	1	4.2	2	4.7	3.38	0.25-46.36
Convulsive crisis	1	4.2	1	2.3	6.75	0.34-130.79
Other:	1	4.2	13	30.2	1	-
Total	24	100.0	43	100.0	-	-

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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[1] Corresponding author: Ricardo Clayton Silva Jansen E-mail: ricardojansen_20@hotmail.com