_id

683a1629c782e11e38d1b233

id

10038

title

Braden Score for Pressure Ulcers

full_title

Braden Score for Pressure Ulcers

short_title

Braden Score

med_description

Identifies patients at risk for pressure ulcers.

short_description

Pressure ulcer risk.

slug

braden-score-pressure-ulcers

description

The Braden Score for Pressure Ulcers classifies the risk for pressure ulcers.

keywords

Braden score, Pressure ulcers, ulcers, bedsores, sores

complaint

[ "Chronic Pain", "Injury/Trauma", "Muscle Stiffness", "Neurologic Deficit", "Numbness", "Rash", "Weakness" ]

formula

Addition of the selected points:

evidence

measurements

[]

information

Interpretation:

Note: universal cutoffs are not prescribed for the Braden Scale, and institutions are encouraged to conduct their own studies in order to determine optimal cutoff points. This stratification is one suggestion from a prospective study by the original authors (Bergstrom 1992).

refrences

{ "Clinical Practice Guidelines": [], "Manufacturer Website": [], "Original/Primary Reference": [ { "href": "https://www.ncbi.nlm.nih.gov/pubmed/3299278 ", "text": "Bergstrom N, Braden BJ, Laguzza A, Holman V. The Braden Scale for Predicting Pressure Sore Risk. Nurs Res. 1987;36(4):205-10." } ], "Other References": [], "Outcomes": [], "Validation": [ { "href": "https://www.ncbi.nlm.nih.gov/pubmed/12464760 ", "text": "Bergstrom N, Braden BJ. Predictive validity of the Braden Scale among Black and White subjects. Nurs Res. 2002;51(6):398-403." }, { "href": "https://www.ncbi.nlm.nih.gov/pubmed/9766454", "text": "Bergstrom N, Braden B, Kemp M, Champagne M, Ruby E. Predicting pressure ulcer risk: a multisite study of the predictive validity of the Braden Scale. Nurs Res. 1998;47(5):261-9." }, { "href": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4042540/ ", "text": "Hyun S, Vermillion B, Newton C, et al. Predictive validity of the Braden scale for patients in intensive care units. Am J Crit Care. 2013;22(6):514-20." }, { "href": "https://www.ncbi.nlm.nih.gov/pubmed/17667086", "text": "Kring DL. Reliability and validity of the Braden Scale for predicting pressure ulcer risk. J Wound Ostomy Continence Nurs. 2007;34(4):399-406." }, { "href": "https://www.ncbi.nlm.nih.gov/pubmed/29078875", "text": "Griswold LH, Griffin RL, Swain T, Kerby JD. Validity of the Braden Scale in grading pressure ulcers in trauma and burn patients. J Surg Res. 2017;219:151-157." }, { "href": "https://www.ncbi.nlm.nih.gov/pubmed/1634717", "text": "Bergstrom N, Braden B. A prospective study of pressure sore risk among institutionalized elderly. J Am Geriatr Soc. 1992;40(8):747-58." } ], "Validations": [] }

pearls

• Regular reassessment is essential, as a patient’s risk level can change rapidly in acute or post-operative settings.
• Targets key modifiable risk factors but does not capture all potential contributors to pressure ulcer formation.
• Has limited interobserver reliability, which may improve with staff training on its use.

usecase

Utilize in conjunction with clinical assessment for hospitalized or immobile patients, particularly in intensive care, post-operative, or long-term care settings, to assess the risk of developing pressure ulcers.

reasons

Validated for predicting a patient's risk of developing pressure ulcers, enabling proactive prevention strategies.

next_advice

• A score indicating an increased risk (be aware that risk group cutoffs may vary between institutions) for the development of pressure-induced skin and soft tissue injury should prompt the initiation of preventive measures targeted at specific risks identified in the assessment, such as frequent repositioning, use of pressure-relieving devices, and addressing nutritional needs. 
• Some institutions may provide care plan recommendations based on Braden Score results, including scores within individual subcategories; refer to local protocols.
• Reevaluate regularly and adjust the care plan as the patient’s condition changes.

next_actions

next_management

diseases

[ "Chronic Pain" ]

input_schema

[ { "inct": null, "option_fhir_rules": null, "subheading": "<p>Select the closest description:</p>", "subheading_instructions": "", "type": "subheading" }, { "conditionality": "", "default": 0, "label_en": "<p>Sensory perception</p>", "mdcalc_info_concept": null, "name": "sensory", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No impairment: responds to verbal commands, able to feel and express pain/discomfort", "value": 4 }, { "label": "Slightly limited: responds to verbal commands but cannot always communicate discomfort or need to be turned, OR has sensory impairment limiting ability to feel pain/discomfort in 1-2 extremities", "value": 3 }, { "label": "Very limited: responds only to pain, cannot communicate discomfort except by moaning or restlessness, OR has sensory impairment limiting ability to feel pain/discomfort over half of body", "value": 2 }, { "label": "Completely limited: unresponsive to painful stimuli due to diminished consciousness or sedation, OR limited ability to feel pain over most of body", "value": 1 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": "", "default": 0, "label_en": "<p>Moisture</p>", "mdcalc_info_concept": null, "name": "moisture", "option_fhir_rules": null, "optional": false, "options": [ { "label": "Rarely moist: skin usually dry, linen only requires changing at routine intervals ", "value": 4 }, { "label": "Occasionally moist: requiring extra linen change approximately once a day", "value": 3 }, { "label": "Very moist: skin is often but not always moist; linen must be changed at least once a shift", "value": 2 }, { "label": "Constantly moist: skin is kept moist almost constantly by perspiration, urine, etc; dampness detected every time patient is moved/turned", "value": 1 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": "", "default": 0, "label_en": "<p>Activity</p>", "mdcalc_info_concept": null, "name": "activity", "option_fhir_rules": null, "optional": false, "options": [ { "label": "Walks frequently: walks outside room ≥2x/day and inside room at least once every 2 hrs during waking hours", "value": 4 }, { "label": "Walks occasionally: during day but for very short distances with or without assistance; spends majority of shift in bed/chair ", "value": 3 }, { "label": "Chairfast: ability to walk severely limited or non-existent; cannot bear own weight and/or must be assisted into chair/wheelchair", "value": 2 }, { "label": "Bedfast: confined to bed", "value": 1 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": "", "default": 0, "label_en": "<p>Mobility</p>", "mdcalc_info_concept": null, "name": "mobility", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No limitation: makes major and frequent changes in position without assistance", "value": 4 }, { "label": "Slightly limited: makes frequent though slight changes in body or extremity position independently ", "value": 3 }, { "label": "Very limited: makes occasional slight changes in body or extremity position but unable to make frequent or significant changes independently ", "value": 2 }, { "label": "Completely immobile: does not make even slight changes in body or extremity position without assistance ", "value": 1 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": "", "default": 0, "label_en": "<p>Nutrition</p>", "mdcalc_info_concept": null, "name": "nutrition", "option_fhir_rules": null, "optional": false, "options": [ { "label": "Excellent: eats most of every meal; never refuses a meal; usually eats ≥4 servings of meat and dairy products; occasionally eats between meals; supplementation not required", "value": 4 }, { "label": "Adequate: eats over half of most meals; eats 4 servings protein (meat or dairy) daily; occasionally refuses meal but will usually take supplement when offered; or is on a tube feeding/TPN regimen which probably meets most of nutritional needs ", "value": 3 }, { "label": "Probably inadequate: rarely eats complete meal and generally eats only about ½ of any food offered; protein intake includes only 3 servings of meat or dairy products daily; occasionally will take dietary supplement; or receives less than optimum amount of", "value": 2 }, { "label": "Very poor: never eats complete meal; rarely eats >⅓ of any food offered; eats ≤2 servings protein (meat or dairy) daily; takes fluids poorly; does not take liquid dietary supplement; or is NPO and/or maintained on clear liquids or IV for >5 days", "value": 1 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": "", "default": 0, "label_en": "<p>Friction and shear</p>", "mdcalc_info_concept": null, "name": "friction", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No apparent problem: moves in bed/chair independently, has sufficient muscle strength to lift up completely during move, maintains good position in bed/chair ", "value": 3 }, { "label": "Potential problem: moves feebly or requires minimum assistance; during a move, skin probably slides to some extent against sheets, chair restraints, or other devices; maintains relatively good position in chair or bed most of the time but occasionally sli", "value": 2 }, { "label": "Problem: requires moderate to maximum assistance in moving; complete lifting without sliding against sheets is impossible; frequently slides down in bed or chair, requiring frequent repositioning with maximum assistance; spasticity, contractures, or agita", "value": 1 } ], "show_points": true, "tips_en": "", "type": "radio" } ]

instructions

published

2022-04-21T20:28:08.575Z

purpose

[ "Prognosis", "Treatment" ]

search_terms

[ "Braden score", "Pressure ulcers", "ulcer risk", "pressure sore", "decub", "decubitus ulcer" ]

seo

{ "keywords_en": "Braden score, Pressure ulcers, ulcers, bedsores, sores ", "meta_description_en": " The Braden Score for Pressure Ulcers classifies the risk for pressure ulcers." }

specialty

[ "Critical Care", "Critical Care (Neurologic)", "Dermatology", "Geriatrics", "Hospitalist Medicine", "Internal Medicine", "Pain Management", "Primary Care", "Surgery (General)", "Surgery (Plastic)" ]

departments

[ "Dermatologic", "Musculoskeletal" ]

tags

[]

version_number

1

versions

[]

related

[ { "calcId": 10059, "short_title_en": "PEDIS Score", "slug": "pedis-score-diabetic-foot-ulcers" }, { "calcId": 10542, "short_title_en": "OSIRIS", "slug": "osteoporosis-index-risk-osiris" }, { "calcId": 10541, "short_title_en": "ORAI", "slug": "osteoporosis-risk-assessment-instrument-orai" } ]

ismed

false

section

[ "whenToUseViewed", "pearlsPitfallsViewed", "whyUseViewed", "nextStepsViewed", "evidenceViewed" ]

cleaned_departments

[ "dermatology", "orthopedics" ]

cleaned_use

[ "Utilize in conjunction with clinical assessment for hospitalized or immobile patients, particularly in intensive care, post-operative, or long-term care settings, to assess the risk of developing pressure ulcers." ]

pub

false