Braden Scale: evaluation of clinical usefulness in an intensive care unit

This paper is a report of a study conducted to determine the usability and utility of the Braden in intensive care units.

An understanding of the clinical usage of the Braden Scale is valuable when considering the incidence of pressure ulcers in a critical-care setting.

A retrospective analysis of 21,115 hospital-days of 715 inpatients in an intensive-care unit in 2006 in South Korea was applied to data extracted electronically from an electronic medical record system in October 2007.

Of the 715 patients, 42 (5.9%) developed a pressure ulcer, corresponding to an incidence density of 198 ulcers per 1000 hospital-days. The usage rate of the Braden Scale was 11.26%, and an analysis of its utility, based on a receiver operating characteristic analysis with the cutoff set at 13, gave sensitivity, specificity, positive predictive values and negative predictive values of 75.9%, 47.3%, 18.1% and 92.8% respectively. There were weak correlations between the scores and nursing interventions except for the category of position changes. The variety of nursing interventions was also limited.

Our data suggest that the Braden Scale has a very low usage rate and a low-to-moderate positive predictive performance. Our quantification of the relationship between Braden Scale score and nursing interventions indicates the need for a more comprehensive and fundamental approach to the use of this scale.