Document Detail


Assessing predictive validity of the modified Braden scale for prediction of pressure ulcer risk of orthopaedic patients in an acute care setting.
MedLine Citation:
PMID:  19490294     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS AND OBJECTIVES: To assess and compare the predictive validity of the modified Braden and Braden scales and to identify which of the modified Braden subscales are predictive in assessing pressure ulcer risk among orthopaedic patients in an acute care setting. BACKGROUND: Although the Braden scale has better predictive validity, literature has suggested that it can be used in conjunction with other pressure ulcer risk calculators or that some other subscales be added. To increase the predictive power of the Braden scale, a modified Braden scale by adding body build for height and skin type and excluding nutrition was developed. DESIGN: A prospective cohort study. METHOD: A total of 197 subjects in a 106-bed orthopaedic department of an acute care hospital in Hong Kong were assessed for their risk for pressure ulcer development by the modified Braden and Braden scales. Subsequently, daily skin assessment was performed to detect pressure ulcers. Cases were closed when pressure ulcers were detected. RESULTS: Out of 197 subjects, 18 patients (9.1%) developed pressure ulcers. The area under the receiver operating characteristic curve for the modified Braden scale was 0.736 and for the Braden scale was 0.648. The modified Braden cut-off score of 19 showed the best balance of sensitivity (89%) and specificity (62%). Sensory perception (Beta = -1.544, OR=0.214, p = 0.016), body build for height (Beta = -0.755, OR = 0.470, p = 0.030) and skin type (Beta = -1.527, OR = 0.217, p = 0.002) were significantly predictive of pressure ulcer development. CONCLUSION: The modified Braden scale is more predictive of pressure ulcer development than the Braden scale. RELEVANCE TO CLINICAL PRACTICE: The modified Braden scale can be adopted for predicting pressure ulcer development among orthopaedic patients in an acute care setting. Specific nursing interventions should be provided, with special attention paid to orthopaedic patients with impaired sensory perception, poor skin type and abnormal body build for height.
Authors:
Wai Shan Chan; Samantha Mei Che Pang; Enid Wai Yung Kwong
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Publication Detail:
Type:  Journal Article; Validation Studies    
Journal Detail:
Title:  Journal of clinical nursing     Volume:  18     ISSN:  1365-2702     ISO Abbreviation:  J Clin Nurs     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-03     Completed Date:  2009-08-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9207302     Medline TA:  J Clin Nurs     Country:  England    
Other Details:
Languages:  eng     Pagination:  1565-73     Citation Subset:  N    
Affiliation:
School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cohort Studies
Female
Hong Kong
Humans
Male
Middle Aged
Orthopedics*
Predictive Value of Tests
Pressure Ulcer / epidemiology*
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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