Magnan Morris A, Maklebust Joann
School of Nursing, Oakland University, Rochester, Michigan, USA.
J Wound Ostomy Continence Nurs. 2008 Mar-Apr;35(2):199-208; discussion 209-12. doi: 10.1097/01.WON.0000313643.60117.b2.
To evaluate the effect of Web-based Braden Scale training on the reliability and precision of pressure ulcer risk assessments made by registered nurses (RN) working in acute care settings.
Pretest-posttest, 2-group, quasi-experimental design.
Five hundred Braden Scale risk assessments were made on 102 acute care patients deemed to be at various levels of risk for pressure ulceration. Assessments were made by RNs working in acute care hospitals at 3 different medical centers where the Braden Scale was in regular daily use (2 medical centers) or new to the setting (1 medical center).
The Braden Scale for Predicting Pressure Sore Risk was used to guide pressure ulcer risk assessments. A Web-based version of the Detroit Medical Center Braden Scale Computerized Training Module was used to teach nurses correct use of the Braden Scale and selection of risk-based pressure ulcer prevention interventions.
In the aggregate, RN generated reliable Braden Scale pressure ulcer risk assessments 65% of the time after training. The effect of Web-based Braden Scale training on reliability and precision of assessments varied according to familiarity with the scale. With training, new users of the scale made reliable assessments 84% of the time and significantly improved precision of their assessments. The reliability and precision of Braden Scale risk assessments made by its regular users was unaffected by training.
Technology-assisted Braden Scale training improved both reliability and precision of risk assessments made by new users of the scale, but had virtually no effect on the reliability or precision of risk assessments made by regular users of the instrument. Further research is needed to determine best approaches for improving reliability and precision of Braden Scale assessments made by its regular users.
评估基于网络的Braden量表培训对急症护理机构注册护士（RN）进行压疮风险评估的可靠性和准确性的影响。
前测-后测、两组、准实验设计。
对102名被认为有不同程度压疮风险的急症护理患者进行了500次Braden量表风险评估。评估由在3个不同医疗中心的急症护理医院工作的注册护士进行，其中2个医疗中心日常常规使用Braden量表，1个医疗中心是首次使用。
采用预测压疮风险的Braden量表指导压疮风险评估。使用底特律医疗中心Braden量表计算机化培训模块的网络版，教导护士正确使用Braden量表以及选择基于风险的压疮预防干预措施。
总体而言，注册护士在培训后65%的时间里能够做出可靠的Braden量表压疮风险评估。基于网络的Braden量表培训对评估可靠性和准确性的影响因对该量表的熟悉程度而异。通过培训，该量表的新用户84%的时间里能够做出可靠评估，且评估准确性显著提高。该量表的常规用户所做的Braden量表风险评估的可靠性和准确性不受培训影响。
技术辅助的Braden量表培训提高了该量表新用户风险评估的可靠性和准确性，但对该量表常规用户风险评估的可靠性或准确性几乎没有影响。需要进一步研究以确定提高该量表常规用户所做Braden量表评估可靠性和准确性的最佳方法。
