What does the Braden scale comprise of?

From the Guidelines

The Braden Scale is a risk assessment tool used to predict pressure ulcer development in patients, comprising six subscales: sensory perception, moisture, activity, mobility, nutrition, and friction/shear. It is used to evaluate a patient's risk of developing pressure ulcers, which are localized injuries to the skin and/or underlying tissue, usually over a bony prominence, as a result of pressure alone or in combination with shear 1. The six subscales of the Braden Scale are:

• Sensory perception: evaluates a patient's ability to respond to pressure-related discomfort
• Moisture: assesses the degree to which skin is exposed to moisture
• Activity: measures the patient's physical activity level
• Mobility: evaluates the patient's ability to change and control body position
• Nutrition: examines the patient's usual food intake pattern
• Friction/shear: assesses the patient's ability to move or be moved without skin damage Each subscale is rated on a scale of 1 to 4 (except friction/shear, which is 1 to 3), with lower scores indicating higher risk 1. The total score ranges from 6 to 23, with scores of 18 or below generally indicating risk for pressure ulcer development 1. This scale helps healthcare providers implement appropriate preventive measures based on individual risk factors, allowing for targeted interventions to prevent pressure injuries. Some of the key points to consider when using the Braden Scale include:
• Identifying high-risk patients and implementing preventive measures to reduce the risk of pressure ulcer development
• Using the scale to evaluate the effectiveness of interventions and adjust the plan of care as needed
• Considering the patient's individual risk factors and developing a personalized plan of care to prevent pressure ulcers
• Using the scale in conjunction with other assessment tools and clinical judgment to ensure accurate risk assessment and effective prevention strategies.

From the Research

Overview of the Braden Scale

The Braden Scale is a widely used pressure ulcer risk assessment system that comprises six subscales:

• Sensory perception
• Moisture
• Activity
• Mobility
• Nutrition
• Friction and shear 2, 3, 4, 5, 6

Subscales of the Braden Scale

Each subscale assesses a different aspect of a patient's condition that may contribute to the risk of developing pressure ulcers:

• Sensory perception: the patient's ability to feel and respond to pain and discomfort
• Moisture: the patient's level of skin moisture, which can increase the risk of pressure ulcers
• Activity: the patient's level of physical activity, which can affect blood flow and pressure on the skin
• Mobility: the patient's ability to move and change positions, which can help prevent pressure ulcers
• Nutrition: the patient's nutritional status, which can affect the health and integrity of the skin
• Friction and shear: the forces that can cause pressure ulcers, such as friction and shear stress on the skin 2, 3, 4, 5, 6

Importance of Each Subscale

Research has shown that some subscales are more important than others in predicting the risk of pressure ulcers:

• Sensory perception is a key factor, as patients with limited sensory perception are more likely to develop pressure ulcers 2, 5
• Mobility is also an important factor, as patients with limited mobility are more likely to develop pressure ulcers 2, 5
• Moisture is another important factor, as patients with high levels of skin moisture are more likely to develop pressure ulcers 5
• Friction and shear are also important factors, as they can cause pressure ulcers even in patients with good mobility and sensory perception 2, 5