Braden Scale in pressure ulcer risk assessment

Jansen, Ricardo Clayton Silva; Silva, Kedyma Batista de Almeida; Moura, Maria Edileuza Soares

doi:10.1590/0034-7167-2019-0413

“…The second most frequently reported diagnoses combination was altered physical mobility and impaired skin integrity. This finding supports previous studies that reported immobility as a risk factor for pressure injury [ 23 , 24 ] and included it in the pressure injury risk assessment scales, such as the Braden scale [ 25 ].…”

Section: Discussionsupporting

confidence: 90%

Nursing diagnoses among oncology patients in medical units: a retrospective study of patients’ records

Othman¹,

Alosta²,

Alshraideh³

et al. 2021

ecancer

1

0

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Objective Nursing care plans for oncology patients are complex and overlapping enough to warrant the need for systematised documentation that ensures high quality, flawless and comprehensive care. Addressing the patients’ needs through nursing diagnoses is the initial step that shapes the subsequent care. Therefore, the current study aimed to identify the frequent NANDA-I diagnoses reported in nursing care plans for medical oncology patients. Data sources A retrospective design was used to collect data from 260 electronic nursing care records of oncology patients admitted to medical floors at an accredited oncology centre in Jordan. Conclusion The complexity of nursing care for oncology patients can be inferred from the high number of reported nursing diagnoses. This study summarises the most common nursing diagnoses and their combinations that can be used as a guide to formulate nursing care plans for oncology patients in medical units. Implications for nursing practice Oncology nurses may refer to this study to guide and support their care and documentations to maintain a high standard of nursing practice. Besides, the reported diagnoses can be integrated to generate pre-printed, standardised nursing care plans, where diagnoses are listed for nurses to select the applicable ones for their patients. Similarly, the combinations of nursing diagnoses may guide nurses to search for a concurrent diagnosis, thus improving patients’ outcomes. This study revealed the complexity of patients’ care in medical oncology units, which alarms the nursing managers to reconsider the nurse–patient ratio in these settings to meet patients’ care demands and maintain their safety.

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“…Critical care resource utilization was captured, including nutrition support (≥75% of nutritional goal, estimated by formula), respiratory therapy including prone positioning, continuous RRT (CRRT), wound/ostomy/continence nursing (WOCN) evaluation, operative management of SF, rehabilitation therapy, palliative care consultation, and limitation of goals of care. Richmond Agitation Sedation Scale (RASS) 26 and Braden scores 27 were calculated at least daily. Use of sedative medications, neuromuscular blockade, and vasopressors was analyzed.…”

Section: Methodsmentioning

confidence: 99%

Skin Failure Among Critically Ill Patients Afflicted with Coronavirus Disease 2019 (COVID-19)

Greenway

¹

,

Leahy

²

,

Torrieri

³

et al. 2021

J Intensive Care Med

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Objective: To characterize skin integrity among coronavirus disease 2019 (COVID-19) patients treated in the intensive care unit (ICU), and identify risk factors for skin failure (SF) in these patients. Design: The characteristic, profound pro-inflammatory, hypercoagulable state of COVID-19 is manifested by the high severity of illness and extensive organ dysfunction observed in these patients. SF in critically ill patients, although described previously, exhibits a uniquely complex pathogenesis in this population. Patients: Retrospective review of all COVID-19 patients (confirmed positive for severe acute respiratory syndrome coronavirus-2 [SARS-CoV-2]) admitted to a single surgical ICU for at least 48 hours between March-June 2020. Interventions: Data were extracted from a COVID-19 institutional data repository that harvested data from electronic health records and other clinical data sources. Demographics; coagulation/inflammation biomarkers; number, location, and stage of SF lesions; resource utilization; and outcomes were captured. Measurements and Main Results: 64 patients met inclusion criteria; 51 (80%) developed SF (SF+ ). Forty-three (85%) developed stage 3 or higher SF (χ2 = 22.66, P < .0001). Thirty-nine of 51 (76%) SF+ patients developed more than one SF lesion (χ2 = 13.26, P = .0003). SF+ patients manifested a profound pro-inflammatory, hypercoagulable phenotype (lower serum albumin and higher ferritin, interleukin [IL]-6 and D-dimer concentrations [all, P < .001]). Durations of mechanical ventilation, vasopressor therapy, and ICU length of stay were significantly longer (all, P < .05) in the SF + patients. Conclusions: The unique characteristics of COVID-19 dermatopathology and the strong correlation between markers of inflammation and development of SF reflect COVID-19-related organ dysfunction and its deleterious effects on the microcirculation. Considering that skin is invaded directly by SARS-CoV-2 and affected by COVID-19-related immune complex deposition and microthrombosis, SF may reflect disease as opposed to pressure injuries related to processes of care. In the context of COVID-19 critical illness, SF should not be considered a “never event.”

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“…PU risk was assessed by the nurse in charge of the ward and the nurse in the operating room 1 d before the operation and 1 w after the operation. The Braden PU risk assessment scale [ 13 ] is used for evaluation, which includes sensation, activity, humidity, movement, friction, and nutrition, with a total score of 23: extremely high risk: ≤9 points, high risk: 10-12 points, medium risk: 13-14 points, and low risk: 15-18 points; the lower the score, the higher the risk of PU.…”

Section: Methodsmentioning

confidence: 99%

Application of Self-Adhesive Soft Silicone Common Foam Dressing in Reducing Intraoperative Pressure Ulcers in Elderly ICU Patients

Wang

¹

,

Gan

²

,

Zhou

³

et al. 2021

Computational and Mathematical Methods in Medicine

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Pressure ulcer (PU), also called pressure injury, is localized damage to the skin and underlying soft tissues, usually over bony prominences, as a result of sustained mechanical loads applied to the tissues. However, in many situations, complete off-loading of sacral PUs is not possible. Minimising the exposure of wounds and their surroundings to elevated mechanical loads is crucial for healing. We for the first time reported the application of Meipicang in the prevention and treatment of intraoperative pressure ulcers in elderly ICU patients with severe illness. We found that the pressure ulcer risk score ( 20.15 ± 2.17 ) in the dressing group after intervention was higher than that ( 17.42 ± 3.62 ) in the regular group. The incidence of pressure sores in the dressing group was 3.77% lower than the 18.88% in the regular group. The psychological concern score ( 31.41 ± 3.15 ) of the dressing group was higher than that ( 26.92 ± 3.43 ) of the regular group. The trust score ( 29.57 ± 2.61 ) of the dressing group was higher than the score ( 24.28 ± 2.29 ) of the regular group. The score of physiological problems in the dressing group ( 34.69 ± 3.82 ) is higher than that in the regular group ( 29.88 ± 3.54 ). The skin complication rate of the dressing group was 5.56% lower than that of the regular group (22.64%). The comfort score (92.46 ± 4.15) of the dressing group was higher than that ( 80.59 ± 5.43 ) of the regular group. The nursing satisfaction score ( 94.53 ± 3.72 ) of the dressing group was higher than that ( 81.79 ± 4.61 ) of the regular group. To conclude, in this study, we found that the Meipicang dressing can reduce the incidence of pressure ulcers in ICU patients with severe ICU and improve the comfort and nursing satisfaction of elderly ICU patients with severe ICU, which is worthy of promotion.

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Braden Scale in pressure ulcer risk assessment

Cited by 42 publications

References 11 publications

Nursing diagnoses among oncology patients in medical units: a retrospective study of patients’ records

Nursing diagnoses among oncology patients in medical units: a retrospective study of patients’ records

Skin Failure Among Critically Ill Patients Afflicted with Coronavirus Disease 2019 (COVID-19)

Application of Self-Adhesive Soft Silicone Common Foam Dressing in Reducing Intraoperative Pressure Ulcers in Elderly ICU Patients

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