Midrange Braden Subscale Scores Are Associated With Increased Risk for Pressure Injury Development Among Critical Care Patients.
Jenny Alderden, Mollie Rebecca Cummins, Ginette Alyce Pepper and 4 others
PMID 28671894WHAT IT FOUND
ICU patients with midrange Braden scores showed the highest pressure injury risk, except friction/shear, where severe scores did.
Nurses should not wait for the most severe Braden scores before reviewing prevention intensity.
Key findings
01Patients with cumulative Braden scores 10 to 12 were 8.4 times more likely to develop a Stage 2 or greater pressure injury than patients with scores 19 or higher.
02Midrange subscale categories carried more risk than the more severe categories: 'often moist' was 12.5 times 'rarely moist', and 'very limited mobility' was 7.7 times no mobility limitation.
03Risk linked to Braden subscales varied by age: older patients with 'walks occasionally' or 'very poor' nutrition were at higher risk, while younger patients were most affected by limited mobility.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study did not record what pressure injury prevention measures were given, so it cannot tell whether midrange scores identify true higher risk or whether patients with more severe scores received more prevention. It was a single-center electronic health record study, so the results may not transfer to other ICUs. Stage 1 pressure injuries were excluded from the primary analysis because transient redness can be hard to distinguish from true tissue injury. The age-related findings are associations from a trauma center where trauma patients were not counted separately, so they cannot prove that age itself caused the differences.
The easy way to misread this
Do not conclude that midrange Braden scores cause pressure injuries or that nurses failed to provide prevention. The study recorded risk scores and pressure injury outcomes, not the preventive measures given, so it cannot show what caused the difference.