Clinical trial of the Braden Scale on an acute care medical unit.

Pressure ulcers in hospitalized patients represent a significant challenge to the health professionals who care for these patients. This challenge extends to the health care system as a whole because of the staggering costs associated with pressure ulcer resolution. Although the relative benefits of various treatment methods have long been debated, intervention before ulcer formation clearly stands as the most efficacious approach to this problem. The Braden Scale for Predicting Pressure Sore Risk, a recently developed paper tool, was evaluated in our acute care medical unit for its ability to predict pressure ulcer occurrence. The sensitivity of the Braden Scale in this evaluation was much lower than that reported in other published studies. The Braden Scale was less effective than the nurse judgment prediction method, the current prevailing prediction method at this institution. The gravity of these results, however, is unclear because of the questionable incidence of ulcers in this study, which may be artificially high due to permissive criteria used in the identification of stage 1 ulcers. We determined that the lack of unequivocally defined criteria for the identification of stage 1 ulcers may contribute to variance between studies. We also found that intervention measures were used only 27% of the time after the identification of patients at risk.