Nursing Department, National University Hospital, Singapore.
The Singapore Centre for Evidence Based Nursing, Nursing Department, National University Hospital, Singapore.
Int Wound J. 2019 Jun;16(3):665-673. doi: 10.1111/iwj.13078. Epub 2019 Feb 7.
The aim of this study was to compare the pressure injury risk predictability between the individual Braden subscales and the total Braden scale in adult inpatients in Singapore. A retrospective 1:1 case-control design was used from a sample of 199 patient medical records. Clinical data were collected from a local university hospital's medical records database. The results showed that, among the six subscales, the activity subscale was the most sensitive and specific in predicting pressure injury (PI). However, the overall results showed that the Braden scale remained the most predictive of PI development in comparison with the individual subscales. The study also found that, among the Singaporean patients, the Braden cut-off score for PI risk was 17 compared with the current cut-off score of 18. Therefore, it may be relevant for local tertiary hospitals to review their respective Braden cut-off scores as the study results indicate an over-prediction of PI risk, which leads to unnecessary utilisation of resources. The hospital may also consider developing a PI prevention bundle comprising commonly used preventive interventions when at least one Braden subscale reflects a suboptimal score.
本研究旨在比较新加坡成人住院患者个体 Braden 子量表与总 Braden 量表在预测压力性损伤（PI）风险方面的差异。采用回顾性 1:1 病例对照设计，从 199 份患者病历中抽取样本。临床数据来自当地一所大学医院的病历数据库。结果表明，在六个子量表中，活动子量表在预测 PI 方面最敏感和特异。然而，总体结果表明，与个体子量表相比，Braden 量表仍然是预测 PI 发展最具预测性的指标。该研究还发现，与当前的 18 分截点相比，新加坡患者的 PI 风险 Braden 截分值为 17。因此，当地的三级医院可能需要重新审查各自的 Braden 截分值，因为研究结果表明对 PI 风险的过度预测会导致不必要的资源利用。医院还可以考虑制定一个 PI 预防套餐，当至少一个 Braden 子量表反映出不理想的分数时，该套餐包含常用的预防干预措施。
