Understanding the Braden Scale
The Origins and Purpose
Developed by nursing professionals Barbara Braden and Nancy Bergstrom, the Braden Scale is a widely used tool for patient care, especially in long-term and senior care settings. Its primary purpose is to identify individuals at risk for pressure ulcers (bedsores) so preventative measures can be implemented. Regular assessment helps healthcare teams tailor care plans.
The Six Components in Detail
The Braden Scale uses six subscales to evaluate factors contributing to pressure ulcer risk. Each is scored 1 to 4 (except friction and shear), with 1 meaning highest impairment and risk. A lower total score indicates greater risk.
1. Sensory Perception
Assesses the ability to detect and respond to pressure discomfort. Lower scores mean less ability to feel or react.
2. Moisture
Measures skin exposure to moisture like sweat or incontinence, which can damage skin.
3. Activity
Evaluates physical movement. Bedfast or chairfast individuals are at higher risk from sustained pressure.
4. Mobility
Assesses the ability to independently change and control body position to relieve pressure points.
5. Nutrition
Considers dietary intake and nutritional status. Poor nutrition weakens skin and impairs healing.
6. Friction and Shear
Scored 1 to 3, this addresses friction (rubbing) and shear (tissue sliding) during movement.
Comparison: Braden Scale vs. Norton Scale
The Braden Scale is a widely used risk assessment tool. Comparing it to the earlier Norton Scale shows differences in criteria.
| Feature | Braden Scale | Norton Scale |
|---|---|---|
| Development Year | 1987 | 1962 |
| Components | Sensory Perception, Moisture, Activity, Mobility, Nutrition, Friction/Shear | Physical Condition, Mental Condition, Activity, Mobility, Incontinence |
| Scoring Range | 6 to 23 | 5 to 20 |
| Risk Threshold | 18 or below (generally) | 14 or below |
| Key Distinction | Includes specific metrics for Friction and Shear, and differentiates Activity and Mobility. | Combines mobility and activity, and lacks a specific friction/shear assessment. |
Implementing the Braden Scale in Care
Using the Braden Scale effectively involves integrating it into patient care.
- Initial Assessment: Patients should be assessed upon admission.
- Regular Reassessment: Reassessment is needed periodically and with condition changes.
- Targeted Interventions: Scores guide specific actions like dietary changes or repositioning.
- Care Plan Development: Scores help create personalized plans to reduce risks.
Preventative Measures Based on Braden Scale
Understanding the Braden score helps tailor prevention:
- Sensory Perception: Conduct frequent skin checks for those with limited sensation.
- Moisture: Use barrier creams and change soiled products promptly.
- Activity/Mobility: Implement regular repositioning and consider support surfaces.
- Nutrition: Monitor intake and consult a dietitian for support.
- Friction/Shear: Use proper techniques and equipment when moving patients.
Conclusion
The Braden Scale is a key tool in care for preventing pressure ulcers. Its six components help assess individual risk factors. Using the scale to identify vulnerabilities allows providers to implement precise preventative strategies. A lower score indicates the need for more intensive care. Integrating the Braden Scale is fundamental to patient safety. For more on prevention, consult resources like the Agency for Healthcare Research and Quality {Link: Agency for Healthcare Research and Quality https://www.ahrq.gov/patient-safety/settings/hospital/complex/pressureulcer/braden-scale-scorecard.html}.
