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

AIM: This paper is a report of a study conducted to determine the usability and utility of the Braden in intensive care units.
BACKGROUND: An understanding of the clinical usage of the Braden Scale is valuable when considering the incidence of pressure ulcers in a critical-care setting.
METHODS: 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.
RESULTS: 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.
CONCLUSION: 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.