Zhu Xiuli, Yang Linhe, Ning Junjie, Li Baoqin, Chen Yang, Luo Zhenyu
Xiuli Zhu, MS, is RN, Deputy Chief Nurse, Neurology, First People's Hospital of Zigong City, Sichuan Province, Zigong, China. Linhe Yang, BS, is RN, Nursing Team Leader, Operating Room, Guangyuan Central Hospital, Sichuan Province, Guanyuan, China. Also at First People's Hospital of Zigong City, Junjie Ning, PhD, is Physician, Research Staff; Baoqin Li, BS, is RN, Nursing Team Leader, ICU; and Yang Chen, BS, is RN, Chief Nurse, NICU. Zhenyu Luo, MS, is RN, Emergency Department, Guangyuan Central Hospital.
Adv Skin Wound Care. 2025 Jun 1;38(5):239-244. doi: 10.1097/ASW.0000000000000301. Epub 2025 Apr 18.
To investigate the performance of the Braden QD Scale in predicting hospital-acquired pressure injuries (HAPIs) in critically ill adult patients and the incidence and factors associated with HAPIs within such patients.
A prospective observational study was conducted in a dual-center comprehensive ICU from June to September 2023. The nurse on duty examined all patients for skin integrity upon admission to the ICU and also scored patients using both the Braden and Braden QD scales. A patient's skin was then checked daily by 14 course-trained nurses until the patient was discharged or transferred out of the ICU. If a suspected HAPI was found, photographs were taken and sent to specialist nurses for confirmation and documentation.
A total of 316 critically ill patients were enrolled in the study, and 79 HAPIs occurred. Fifty-five patients (17.4%) had pressure injuries (PIs), 35 patients (11.1%) had medical device-related PIs, and 14 patients (4.4%) had both medical device-related PIs and PIs. Essential predictors of HAPIs were detected. Further, the Braden QD Scale performed better than the Braden Scale in predicting HAPI development in critically ill adults, with the area under the curve being 0.77 (CI, 0.75-0.84) on admission.
The incidence of HAPIs in critically ill adult patients is high, with several influencing factors. The Braden QD Scale emerges as a validated predictive tool for HAPIs in critically ill adult patients, demonstrating clinical utility that warrants additional investigation to optimize prevention strategies.
探讨Braden QD量表在预测成年重症患者医院获得性压疮（HAPI）方面的性能，以及此类患者中HAPI的发生率和相关因素。
于2023年6月至9月在一个双中心综合重症监护病房进行了一项前瞻性观察研究。值班护士在患者入住重症监护病房时检查其皮肤完整性，并使用Braden量表和Braden QD量表对患者进行评分。然后由14名经过培训的护士每天检查患者的皮肤，直至患者出院或转出重症监护病房。如果发现疑似HAPI，拍摄照片并发送给专科护士进行确认和记录。
共有316例成年重症患者纳入研究，发生79例HAPI。55例患者（17.4%）发生压疮（PI），35例患者（11.1%）发生与医疗器械相关的PI，14例患者（4.4%）同时发生与医疗器械相关的PI和PI。检测到HAPI的重要预测因素。此外，在预测成年重症患者HAPI发生方面，Braden QD量表的表现优于Braden量表，入院时曲线下面积为0.77（CI，0.75 - 0.84）。
成年重症患者中HAPI的发生率较高，且存在多种影响因素。Braden QD量表成为成年重症患者HAPI的有效预测工具，显示出临床实用性，值得进一步研究以优化预防策略。
