Braden pressure ulcer risk scale

Introduction

Prodedure:

• 6 subscales (Braden & Bergstrom 1987)
  • sensory perception (response to discomfort of pressure)
  • skin moisture
  • physical activity
  • nutrition (usual food intake pattern)
  • friction & shear
  • mobility (ability to change & control body position)
• all subscales are rated 1 (least favorable) to 4 (most favorable), except friction & shear (1-3)

* persons with darker skin at risk of later detection of pressure injury

• nonblanching erythema in darker-skinned populations may be difficult to detect

Interpretation

• range of scores is 6-23
• low score = high risk
• score < 17, indicates risk (acute care)
• score > 17, indicates low risk (long-term care)
• score of < 11, indicates high risk
• sensitity 100%, 90% specificity of scale (reportedly)
• optimal cutoff scores, to be determined by each facility

Notes

• validated in non-white populations

More general terms

• pressure ulcer risk scale

Additional terms

• pressure ulcer (decubitus ulcer, bedsore)