All at-risk patients are not created equal: analysis of Braden pressure ulcer risk scores to identify specific risks

Journal of Wound, Ostomy, and Continence Nursing : Official Publication of the Wound, Ostomy and Continence Nurses Society
Ann N TescherJames M Naessens

Abstract

To improve identification of risk factors for pressure ulcer development and enhance targeted interventions and prevention strategies. The records of 12,566 adult patients hospitalized in intensive or progressive care units within Mayo Clinic were analyzed. Inclusion criteria were Braden Scale of 18 or less during the hospitalization; exclusion criteria were preexisting pressure ulcer or length of stay less than 24 hours. This study is a retrospective cohort analysis of electronic medical record data from January 1, 2007, to December 31, 2007. Only iatrogenic stage 2 to 4 pressure ulcers were considered as incident events. Demographic and clinical data were extracted from the medical record, including total Braden Scale score and Braden subscale scores at hospital admission, length of stay, admission to the intensive care unit at the time of hospitalization, and presence of acute respiratory failure, acute renal failure, or diabetes. Time to event was calculated based on time from admission to pressure ulcer occurrence or to hospital discharge. Four hundred sixteen (3.3%) of patients developed a pressure ulcer during their hospitalizations. The Braden Scale score total by itself was found to be highly predictive of pressure ulc...Continue Reading

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