The Braden Score is a widely used tool for assessing a patient's risk of developing pressure ulcers (also known as bedsores or pressure injuries). Developed by Barbara Braden and Nancy Bergstrom in 1984 (some sources cite 1988), it helps healthcare professionals identify individuals who need preventative measures.
How the Braden Scale Works
The Braden Scale consists of six subscales, each contributing to the overall score:
- Sensory Perception: Assesses the patient's ability to feel discomfort.
- Moisture: Evaluates the degree of skin exposure to moisture.
- Activity: Measures the patient's physical activity level.
- Mobility: Assesses the patient's ability to change and control body position.
- Nutrition: Evaluates the patient's nutritional intake.
- Friction and Shear: Assesses the potential for skin damage due to friction and shear forces.
Each subscale is scored individually (usually from 1 to 4), and the scores are summed to arrive at a total Braden score ranging from 6 to 23.
Interpreting the Braden Score
- Lower scores (6-12): Indicate a high risk of pressure ulcer development. These patients require intensive preventative measures.
- Moderate scores (13-18): Indicate a moderate risk. Preventative measures should be implemented.
- Higher scores (19-23): Indicate a low risk. While preventative measures are still recommended, the intensity can be lower. A commonly accepted cutoff score for moderate-high risk is 18.
Factors Contributing to Risk
The Braden Scale considers several factors that increase the risk of pressure ulcers, including:
- Decreased sensory perception: Inability to feel pressure or discomfort.
- Increased moisture: Prolonged exposure of skin to moisture.
- Decreased activity: Limited mobility and physical activity.
- Impaired mobility: Difficulty changing body position.
- Inadequate nutrition: Poor nutritional status weakens the skin.
Example: A patient with a Braden score of 10 is considered at high risk and would require frequent repositioning, pressure-relieving surfaces, and meticulous skin care.
The Braden Scale is a valuable tool for proactive pressure ulcer prevention, assisting in the early identification of at-risk patients and guiding appropriate interventions. Its use is prevalent across various healthcare settings.
