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Predictive risk scales for development of pressure ulcers in pediatric patients admitted to general ward and
Wen-Jun Luo1, Xue-Zhen Zhou2, Jia-Ying Lei1
1Sun Yat-sen Memorial Hospital, Guangzhou 510235, Guangdong Province, China.
Insights
Pediatric nurses can effectively use the Braden Q scale to identify high-risk patients for pressure ulcers in the pediatric intensive care unit (PICU). This scale demonstrates better specificity compared to Waterlow and Glamorgan scales.
Area of Science:
- Pediatric Nursing
- Critical Care Medicine
- Wound Prevention
Background:
- Numerous scales exist for predicting pressure ulcer risk in children.
- A comparative analysis of these scales' performance in China was lacking.
Purpose of the Study:
- To compare the efficacy of the Waterlow, Braden Q, and Glamorgan scales.
- To determine the most suitable scale for pressure ulcer risk assessment in the pediatric intensive care unit (PICU).
Main Methods:
- Trained nurses assessed pediatric patients using the Waterlow, Braden Q, and Glamorgan scales.
- Skin examinations were conducted every 3 days for 3 weeks to detect pressure ulcers.
Main Results:
- Pressure ulcer incidence was 10.7% in the PICU and 1.6% in general pediatric wards.
- All scales showed comparable performance in general wards (AUCs ~0.87-0.92).
- In the PICU, Braden Q demonstrated satisfactory specificity, with an AUC of 0.810 in the second stage.
Conclusions:
- The Waterlow, Braden Q, and Glamorgan scales exhibit comparable performance.
- The Braden Q scale offers superior specificity for identifying high-risk pediatric patients in the PICU.
- Pediatric nurses can confidently utilize the Braden Q scale for pressure ulcer risk assessment in the PICU.
Background:
More than ten special scales are available to predict the risk of pressure ulcers in children. However, the performances of those scales have not yet been compared in China.
Aim:
To compare the Waterlow, Braden Q, and Glamorgan scales, and identify more suitable pressure ulcer evaluation scale for the pediatric intensive care unit (PICU).
Methods:
Trained nurses used the Waterlow, Braden Q, and Glamorgan scales to assess pediatric patients at Sun Yat-sen Memorial Hospital (China) within 24 h of admission from May 2017 to December 2020 in two stages. Skin examination was carried out to identify pressure ulcers every 3 d for 3 wk.
Results:
The incidence of pressure ulcers was 3/28 (10.7%) in the PICU and 5/314 (1.6%) in the general pediatric ward. For children in the general ward, the Waterlow, Braden Q, and Glamorgan scales had comparable area under the operating characteristic curve (AUC) of 0.870, 0.924, and 0.923, respectively, and optimal cut-off values of 14, 14, and 29 points. For PICU, the Waterlow, Braden Q, and Glamorgan scales had slightly lower AUC of 0.833, 0.733, and 0.800, respectively, and optimal cut-off values of 13, 16, and 27 points. Braden Q demonstrated a satisfactory specificity, and during the second stage of the study for PICU patients, the AUC of the Braden Q scale was 0.810, with an optimal cut-off value of 18.35 points.
Conclusion:
The Waterlow, Braden Q, and Glamorgan scales have comparable performance, while the Braden Q scale demonstrates a better specificity and can be successfully used by pediatric nurses to identify patients at high risk of pressure ulcers in PICU.
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