Reducing pressure ulcer incidence through Braden Scale risk assessment and support surface use

Area of Science:

• Healthcare Quality Improvement
• Patient Safety
• Wound Prevention

Background:

• Hospital-acquired pressure ulcers remain a significant challenge, with recent surveys showing little progress in reducing incidence.
• Early identification and intervention are crucial, especially considering the deep tissue origins of some pressure ulcers.

Purpose of the Study:

• To identify hospitals that have successfully reduced pressure ulcer incidence.
• To provide evidence-based guidance for implementing effective pressure ulcer prevention strategies.

Main Methods:

• Literature review of PubMed to identify hospitals using the Braden Scale for risk assessment and pressure-reducing surfaces for intervention.
• Analysis of reported nosocomial prevalence rates before and after program implementation in nine identified hospitals.
• Statistical measures, including meta-analysis, to establish confidence limits for incidence reduction.

Main Results:

• Nine hospitals demonstrated significant reductions in pressure ulcer incidence following risk assessment and intervention.
• A meta-analysis showed a significant odds ratio for incidence reduction (0.220 to 0.508).
• Reported cost savings were associated with reduced need for specialized, high-cost therapy equipment.

Conclusions:

• Systematic risk assessment using the Braden Scale and provision of specialized support surfaces are effective in reducing hospital-acquired pressure ulcers.
• Proactive intervention, addressing potential deep tissue injury, is essential and should not be delayed until superficial signs appear.