The Psychometric Properties of the Braden Scale to Assess Pressure Injury Risk in Acute Care: A Systematic Review.

The review applies only to adult acute care outside ICU, so it does not tell nurses how the scale performs in ICU, long-term care or community settings. Only English-language studies were included, so relevant evidence in other languages may be missing. The included studies were very different in design, population and analysis, so the review could not combine their results statistically. Risk of bias ratings were recorded but poor-quality studies were still included, and some studies did not clearly report sample size. Reliability studies did not report measurement error, so confidence in detecting clinically important changes is limited. Several Braden items are subjective, and nurse agreement on those items varied. Most validity evidence was about predicting pressure injury occurrence, not about whether the scale identifies risk accurately enough to guide prevention.

The review received no funding, and the authors declared no conflicts of interest.

Do not treat good reliability as proof that the Braden Scale accurately identifies patients who will develop pressure injury. The review found validity varied widely, and recommended cut-off scores were inconsistent across studies.