Preventing pressure sores in oncology patients.

This project addresses staff nurses' concerns about the development of hospital-acquired pressure sores in cancer patients. The Braden Scale and the National Pressure Sore Advisory Panel Staging System were pilot tested. The incidence of hospital-acquired pressure sores was 8% and a mean Braden score of 16 was sufficiently sensitive (82%) and specific (84%) for use with our patient population. Eighty-two percent (9/11) of the patients with a score of 16 on the Braden Scale developed a pressure sore that day. The model of pressure sore development constructed by Braden and Bergstrom (1987) was used to guide the development of a pressure sore prevention protocol. The pilot test of this protocol over 6 months showed no decline in the incidence of hospital-acquired pressure sores and a reduction in the sensitivity and specificity of the Braden Scale. Possible explanations for this finding and revisions to the protocol are suggested.