Pressure injury risk assessment in intensive care units: Comparison of the reliability and predictive validity of the Braden and Jackson/Cubbin scales

Adibelli, Seyma; Korkmaz, Fatoş

doi:10.1111/jocn.15054

Cited by 28 publications

(40 citation statements)

References 38 publications

(59 reference statements)

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“…Coincident with views of some researchers such as Oliveira AL, it suggested that relative temperature measurement of local skin was more accurate than Braden score, an overall assessment for predicting PI (Oliveira et al, 2017). In addition, our study results showed that the optimal cut‐off value of Braden scale for predicting the risk of PI was 14 points, which was lower than the cut‐off value (18 points) used in clinical setting now (Adibelli & Korkmaz, 2019). A higher warning cut‐off value may overestimate the risk of PI in patients, which may be followed by an over use of interventions, leading to a waste of medical resources.…”

Section: Discussionmentioning

confidence: 56%

“…Nurses play a key role in assessing and identifying patients at risk and in implementing adequate preventive measures (Wound & Continence Nurses Society‐Wound Guidelines Task, 2017). However, current risk assessment scales are unable to accurately assess risk (Adibelli & Korkmaz, 2019). And it is easy for clinical nurses to become complacent over time for scale score, which results in poor triggers for taking preventive measures.…”

Section: Introductionmentioning

confidence: 99%

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Application of infrared thermography in the early warning of pressure injury: A prospective observational study

Cai

Jiang

Hou³

et al. 2021

Journal of Clinical Nursing

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Aims and objectives To verify the ability of infrared thermography in objectively identifying pressure injury and its application value in the early warning of pressure injury. Background There is subjectivity in assessing the risk of pressure injury as well as diagnosis in clinical settings, which makes early detection and prevention difficult. Design Prospective, cohort study. Method Four hundred and fifteen patients admitted to the adult intensive care units were enrolled by a convenience sampling method, and they received a follow‐up monitoring for 10 days. The risk of pressure injury was assessed via Braden scale, and thermal images of sacral area were obtained by infrared thermal imager once a day. The predictive effects of infrared thermography and Braden scale on pressure injury were compared by the receiver operating characteristic curve from which the optimal cut‐off value of skin temperature for predicting pressure injury was determined. The effect of skin temperature on pressure injury was described and compared, using Kaplan–Meier curve and Cox proportional hazard regression model, respectively. We followed STROBE checklist for reporting the study. Results The relative temperature of sacral area was negatively correlated with the risk of pressure injury. The efficiency of infrared thermography for diagnosing pressure injury was better than that of Braden scale. Based on the relative temperature optimal cut‐off value (−0.1°C), Kaplan–Meier curve and Cox proportional hazard regression model analysis showed the incidence of pressure injury with relative temperature below −0.1°C was higher than the group with relative temperature above −0.1°C. Conclusions Infrared thermography can objectively and accurately identify local hypothermia warnings of pressure injury before visual recognition. The application of infrared thermography into routine pressure injury risk assessment provides a timely and reliable method for nursing practitioners. Relevance to clinical practice Infrared thermography has great value of clinical application in daily pressure injury assessment. It is of great significance to make a faster and more objective clinical judgement for patients at risk of pressure injury.

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Section: Discussionmentioning

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Application of infrared thermography in the early warning of pressure injury: A prospective observational study

Cai

Jiang

Hou³

et al. 2021

Journal of Clinical Nursing

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“…From February 4 to April 12, 2020, 109 severely ill patients, who were diagnosed by a positive pharyngeal swab at least twice, were admitted to the ICU of the Sino‐French Branch of Tongji Hospital. We observed various stages of pressure injury in nearly 42.2% of COVID‐19 patients (27 male, 19 female) in the ICU, 8 which was considerably higher than usual pressure injury incidence in ICUs (13.6%‐20.1%), 9 despite proper management such as pressure redistribution, anti‐shock therapy, and close daily monitoring 10 . Among these 46 patients, 24 did not have enough exudates from the wounds and these patients were excluded from the study.…”

Section: Methodsmentioning

confidence: 73%

SARS‐CoV‐2 not found in pressure injury exudates from COVID‐19 patients

Zhang

Xiao

et al. 2020

J of Cosmetic Dermatology

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Background The emergence of COVID‐19 has become a global health emergency. The transmissibility of the disease is of great interest to healthcare workers and scientists alike. The primary route of transmission is via respiratory droplets, but viral RNA has also been found in feces and body fluids such as urine, serum, and semen. So far, there has been no report on whether SARS‐CoV‐2 is present in the exudates of cutaneous lesions. This study was designed to investigate whether SARS‐CoV‐2 can be found in the pressure injury exudates in patients with severe COVID‐19 infections. Methods 46 critically ill COVID‐19 patients who were admitted to the ICU of the Sino‐French New City Branch of Tongji Hospital in Wuhan between February 4 and April 12 developed pressure injuries. 22 patients with pressure injuries had wound exudates. Wound and pharyngeal swabs of the 22 patients were collected and RT‐PCRs were conducted to detect SARS‐CoV‐2 viral RNA. Results At the time of pressure injury, 5 patients still tested positive by pharyngeal swabs, the rest of the 17 patients tested negative. However, none of the wound exudate swabs from the participants tested positive for SARS‐CoV‐2 by RT‐PCR. Conclusion Our study suggests that it is rather unlikely that COVID‐19 can be transmitted via pressure injury exudates, but we still recommend standardized personal protective equipment, face shield and an additional pair of gloves when treating pressure injuries.

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“…The Cubbin-Jackson scale has similar predictive values to the Braden scale [ 29 ]. In a prospective observational study, the Cubbin/Jackson scale was indeed more specific than the Braden scale, whilst maintaining acceptable sensitivity [ 34 ]. However, the results may be affected by the small sample.…”

Section: Resultsmentioning

confidence: 99%

The prevention of pressure injuries in the positioning and mobilization of patients in the ICU: a good clinical practice document by the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI)

Ippolito

Cortegiani

Biancofiore

et al. 2022

J Anesth Analg Crit Care

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Background The aim of this document is to support clinical decision-making concerning positioning and mobilization of the critically ill patient in the early identification and resolution of risk factors (primary prevention) and in the early recognition of those most at risk (secondary prevention). The addresses of this document are physicians, nurses, physiotherapists, and other professionals involved in patient positioning in the intensive care unit (ICU). Methods A consensus pathway was followed using the Nominal Focus Group and the Delphi Technique, integrating a phase of focused group discussion online and with a pre-coded guide to an individual phase. A multidisciplinary advisory board composed by nine experts on the topic contributed to both the phases of the process, to reach a consensus on four clinical questions positioning and mobilization of the critically ill patient. Results The topics addressed by the clinical questions were the risks associated with obligatory positioning and therapeutic positions, the effective interventions in preventing pressure injuries, the appropriate instruments for screening for pressure injuries in the ICU, and the cost-effectiveness of preventive interventions relating to ICU positioning. A total of 27 statements addressing these clinical questions were produced by the panel. Among the statements, nine provided guidance on how to manage safely some specific patients’ positions, including the prone position; five suggested specific screening tools and patients’ factors to consider when assessing the individual risk of developing pressure injuries; five gave indications on mobilization and repositioning; and eight focused on the use of devices, such as positioners and preventive dressings. Conclusions The statements may represent a practical guidance for a broad public of healthcare professionals involved in the management of critically ill patients.

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Pressure injury risk assessment in intensive care units: Comparison of the reliability and predictive validity of the Braden and Jackson/Cubbin scales

Cited by 28 publications

References 38 publications

Application of infrared thermography in the early warning of pressure injury: A prospective observational study

Application of infrared thermography in the early warning of pressure injury: A prospective observational study

SARS‐CoV‐2 not found in pressure injury exudates from COVID‐19 patients

The prevention of pressure injuries in the positioning and mobilization of patients in the ICU: a good clinical practice document by the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI)

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