Predicting Pressure Ulcer Development in Clinical Practice

Miller, Natasha; Frankenfield, David C.; Lehman, Erik; Maguire, Melissa; Schirm, Victoria

doi:10.1097/won.0000000000000184

Cited by 19 publications

(15 citation statements)

References 14 publications

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“…While various authors have claimed that PIs typically develop within the first 2 weeks of hospitalisation. 32,33 The cases in this study stayed for twice as long before the occurrence of PI. It was surprising that most PIs in our study were Stage 2 or unstageable considering that they were from the general wards, with more stable conditions, and should therefore be less prone to acquiring severe PIs.…”

Section: Discussionmentioning

confidence: 69%

“…4,38 Patients who are frequently exposed to moisture from urine, stools, or wound drainage are also more prone to impaired skin integrity. 32 In patients with altered mobility, their abilities to change and control their body positions are diminished, increasing their potential for exposure to prolonged and intense pressure. 39 Therefore, patients with changes in mobility levels are more vulnerable to develop PIs and entail more intensive and specific nursing interventions than the rest.…”

Section: Predictors Of Pi Developmentmentioning

confidence: 99%

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Using the Braden subscales to assess risk of pressure injuries in adult patients: A retrospective case‐control study

Lim

Mordiffi

Chew

et al. 2019

International Wound Journal

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The aim of this study was to compare the pressure injury risk predictability between the individual Braden subscales and the total Braden scale in adult inpatients in Singapore. A retrospective 1:1 case‐control design was used from a sample of 199 patient medical records. Clinical data were collected from a local university hospital's medical records database. The results showed that, among the six subscales, the activity subscale was the most sensitive and specific in predicting pressure injury (PI). However, the overall results showed that the Braden scale remained the most predictive of PI development in comparison with the individual subscales. The study also found that, among the Singaporean patients, the Braden cut‐off score for PI risk was 17 compared with the current cut‐off score of 18. Therefore, it may be relevant for local tertiary hospitals to review their respective Braden cut‐off scores as the study results indicate an over‐prediction of PI risk, which leads to unnecessary utilisation of resources. The hospital may also consider developing a PI prevention bundle comprising commonly used preventive interventions when at least one Braden subscale reflects a suboptimal score.

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Section: Discussionmentioning

confidence: 69%

Section: Predictors Of Pi Developmentmentioning

confidence: 99%

Using the Braden subscales to assess risk of pressure injuries in adult patients: A retrospective case‐control study

Lim

Mordiffi

Chew

et al. 2019

International Wound Journal

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show abstract

“…-Shear assessment (e.g. no problem or potential/actual problem) 8/12 -Greater friction and shear results in increased risk for PI development Aljezawi et al, 2014;Cowan et al, 2012;Demarre et al, 2015;Kaitani et al, 2010;Lahmann & Kottner, 2011;Raju et al, 2015;Rao et al, 2016;Schoonhoven et al, 2006;Shahin et al, 2010;Tescher et al, 2012;Shaw et al, 2014 Tissue tolerance Slowikowski & Funk, 2010;Tsaousi et al, 2014;Fred et al, 2012;Miller et al, 2016;Shahin et al, 2010;Aljezawi et al, 2014;Cowan et al, 2012;Rao et al, 2016;Michel et al, 2012;Serra et al, 2014;Kaitani et al, 2010;…”

Section: Shearmentioning

confidence: 99%

“…-Admission total Braden score 21/24 -Lower total Braden scores increase the risk of PI development -Admission Braden score predictive of PI development Tschannen et al, 2012;Cremasco et al, 2013;Rao et al, 2016;Hayes et al, 2015;Delmore et al, 2015;Baldi et al, 2010;Hyun et al, 2014;Shahin et al, 2010;Cowan et al, 2012;Demarre et al, 2015;Miller et al, 2016;Raju et al, 2015;Slowikowski & Funk, 2010;Tescher et al, 2012;Corniello et al, 2014;Smit et al, 2016;Bredesen et al, 2015;Sardo et al, 2016;Connor et al, 2010;Coleman et al, 2013;Fred et al, 2012;Shaw et al, 2014 Episode of care…”

Section: Shearmentioning

confidence: 99%

The pressure injury predictive model: A framework for hospital‐acquired pressure injuries

Tschannen

Anderson

2020

Journal of Clinical Nursing

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Background Despite decades of research, pressure injuries continue to be a source of significant pain and delayed recovery for patients and substantial quality and cost issues for hospitals. Consideration of the current thinking around pressure injury risk must be evaluated to improve risk assessments and subsequent nursing interventions aimed at reducing hospital‐acquired pressure injuries. Design This is a discursive paper using Walker and Avant’s (2005) theory synthesis framework to examine the relevance of existing pressure injury models as they align with the current literature. Methods PubMed and CINAHL indexes were searched, first for conceptual models and then for pressure injury research conducted on hospitalised patients for the years 2006–2016. A synthesis of the searches culminated into a new pressure injury risk model. Conclusions Gaps in previous models include lack of attention to the environment, contributing episode‐of‐care factors and the dynamic nature of injury risk for patients. Through theory synthesis, the need for a new model representing the full risk for pressure injury was identified. The Pressure Injury Predictive Model is a representation of the complex and dynamic nature of pressure injury risk that builds on previous models and addresses new patient, contextual and episode‐of‐care process influences. The Pressure Injury Predictive Model (PIPM) provides a more accurate picture of the complexity of contextual and process factors associated with pressure injury development. Relevance to Clinical Practice Using the PIPM to determine risk can result in improved risk identification. This information can be used to implement targeted, evidence‐based pressure injury prevention interventions specific to the patient risk profile, thus limiting unwarranted and unnecessary care.

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“…Several studies on PU predictors report a correlation between PU and gender (Nakamura et al, 2015), age (Bredesen, Bjoro, Gunningberg, & Hofoss, 2015;Moore et al, 2015), consciousness status (Iranmanesh, Rafiei, & Sabzevari, 2012), nutrition (Miller, Frankenfield, Lehman, Maguire, & Schirm, 2016), faecal and/or urine problem (Jenkins & O'Neal, 2010), pain (Skogestad et al, 2017), type of admission (Garcez Sardo et al, 2016) and mobility (Coleman et al, 2013). In particular, age over 70 years is a significant predictor (Bredesen et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Predictors of hospital‐acquired pressure ulcers among older adult inpatients

Han

Kim

Hwang

et al. 2018

Journal of Clinical Nursing

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Predicting Pressure Ulcer Development in Clinical Practice

Abstract: Findings indicate that the overall Braden score is a valid predictor of PU development. Implications for clinical practice to decrease the risk for PU development include appropriate use of reliable and valid scales by nurses along with careful evaluation of nutrition parameters.

Cited by 19 publications

References 14 publications

Using the Braden subscales to assess risk of pressure injuries in adult patients: A retrospective case‐control study

Using the Braden subscales to assess risk of pressure injuries in adult patients: A retrospective case‐control study

The pressure injury predictive model: A framework for hospital‐acquired pressure injuries

Predictors of hospital‐acquired pressure ulcers among older adult inpatients

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