Pressure Ulcer Risk Assessment

Background Each year, more than 2.5 million people in the United States develop pressure ulcers (Berlowitz, 2014). “Skin lesions bring pain, infection risk, and increased health care utilization. Moreover, Centers for Medicare and Medicaid no longer provides reimbursement to hospitals to care for a patient who has acquired a pressure ulcer while under the hospital’s care” (Berlowitz, 2014, p. 1). Thus, pressure ulcer prevention has become a priority in hospitals. The first step in pressure ulcer prevention is predicting those who are at risk for developing pressure ulcers. Pressure ulcer prediction is done using a skin assessment scale. Two skin assessment scales were evaluated for predictive validity of pressure ulcers, they were, the Braden scale and the modified Braden scale.
Pressure ulcers are an area of skin that breaks down when something continuously rubs or presses against the skin (Berman, 2012). “Pressure on the skin reduces blood, the skin can die. An ulcer may form” (Berman, 2012, p.1). This is …show more content…
515). The Braden scale measures the risk for the development of a pressure ulcer by using 6 subscales: sensory perception, moisture, activity, mobility, nutrition, and friction/shear (Hyun, 2013). “Each of the subscales is scored from 1 to 4 (1-3 for friction/shear), with 1 representing the highest risk. The summative Braden score ranges from 6 to 23” (Hyun, 2013, p. 515). The lower the total score on the Braden scale the greater the risk for developing a pressure ulcer. “Eighteen is the cutoff score that is generally accepted in practice across clinical settings in the United States for predicting risk of pressure ulcers; however, a score of 16 has been recommended for ICU patients” (Hyun, 2013, p. 515). This cutoff score tells nurses that nursing intervention should be applied to patients with low scores in hopes of preventing pressure