VandenBosch T, Montoye C, Satwicz M, Durkee-Leonard K, Boylan-Lewis B
Mission Health, St. Joseph Mercy Hospital, Ann Arbor, MI 48106, USA.
Appl Nurs Res. 1996 May;9(2):80-6. doi: 10.1016/s0897-1897(96)80457-5.
Before the implementation of the Braden Scale, an institutional study was conducted to determine the cut-off point at which patients would be at risk for developing a pressure ulcer. Nurses' perception of patient risk for pressure ulcer development also was compared with the Braden Scale. One hundred and three subjects hospitalized for a minimum of 7 days and randomly selected from routine hospital admissions were rated with the Braden Scale, and skin assessments were made three times per week for up to 2 weeks starting 24 to 48 hours after admission. In addition, bedside nurses were asked to use clinical judgment to identify subjects at risk for pressure ulcer development. Twenty-nine subjects developed pressure ulcers. Nurse's judgements of pressure ulcer risk were not significant in predicting pressure ulcer positive or negative status. Results of the t test demonstrated the Braden Scale score is the most highly significant finding (p = .0038) to predict pressure ulcer positive and pressure ulcer negative groups. For this study, the Braden Scale cut-off point was set at 17 with a sensitivity of .59 and a specificity of .59. Clinical implementation of the Braden Scale must be combined with frequent and thorough skin assessment practices because some patients will develop pressure ulcers even though the tool does not predict the patients to be at risk.
在实施Braden量表之前，进行了一项机构研究，以确定患者发生压疮的风险临界点。同时，还将护士对患者发生压疮风险的认知与Braden量表进行了比较。从常规住院患者中随机选取103名住院至少7天的受试者，使用Braden量表进行评分，并在入院后24至48小时开始，每周进行三次皮肤评估，持续两周。此外，要求床边护士运用临床判断来识别有发生压疮风险的受试者。29名受试者发生了压疮。护士对压疮风险的判断在预测压疮阳性或阴性状态方面并不显著。t检验结果表明，Braden量表评分是预测压疮阳性组和压疮阴性组最具显著性的发现（p = .0038）。在本研究中，Braden量表的临界点设定为17，敏感性为.59，特异性为.59。Braden量表的临床应用必须与频繁且全面的皮肤评估实践相结合，因为即使该工具未预测患者有风险，仍有一些患者会发生压疮。
