USING BRADEN SUBSCALES TO ASSESS PRESSURE INJURY RISK IN SINGAPORE ADULT PATIENTS: A RETROSPECTIVE STUDY

Abstract

Background With rising global incidence of pressure injuries (PIs), it is critical to examine the most suitable tool in the prediction of PI risk. As existing literature purports a lack of association between the total Braden score and preventive interventions, recognising the predictive validity of each Braden subscale in the prediction of PI risk may be paramount in order to direct preventive interventions to patients’ true needs. Aim This study aims to examine and compare the predictive measures of the Braden subscales in providing a specific and sensitive PI risk assessment among adult patients in a public tertiary hospital in Singapore. Methods A retrospective case-control design was adopted using a total sample of 199 subjects, classified into 100 cases and 99 controls. Cases were selected from medical records of patients who had acquired at least one PI during hospitalisation, whereas controls were of patient records without injury. Matching was conducted on a 1:1 ratio. Data was collected using a data collection tool from a database of medical records in the study hospital. Data analysis was conducted using SPSS Version 24.0 to analyse descriptive and inferential statistics. xi Results All Braden subscales were found to be significant predictors of PI development in this study. Specifically, a cut-off score of 17 on the Braden Scale was best predictive of PI risk. The total Braden score remains the most accurate form of PI risk assessment in comparison to all of the subscale scores. Implications The current Braden Scale score cut-off may be reviewed and revised in the study site to minimise over-prediction of PI risk. Training programs may also be inculcated to educate nurses to link the Braden subscale scores to appropriate preventive interventions. Conclusion By recognising the importance of these operationalised risk factors as established in this study, nurses are more empowered to plan and initiate more specific and appropriate preventive interventions based on Braden subscale scores, henceforth achieving better patient outcomes.