engleski

The Harmonization of Braden Scale Assessments with Planned Interventions in Pressure Ulcer Prevention

Introduction: The Braden scale is a tried and tested pressure ulcer risk assessment scale. It is part of nursing documentation in the Republic of Croatia and is used in all hospitals as a tool for pressure ulcer risk assessment. By using the Braden scale, nurses can determine which interventions should be performed to prevent pressure ulcers. Aim: A prospective study was conducted in the Respiratory Intensive Care Unit during one month, with the goal of determining the harmonization level between the Braden scale assessment and the planned interventions for the nursing diagnosis of “high risk of pressure ulcers”. The aim was also to determine if the Braden scale assessment is used for all admitted patients, if the Braden scale assessment is used daily for all patients and if nursing care plans are made for patients who have a risk of pressure ulcer development. Methods: A form was created for the purpose of conducting this study. The form contains patient data on sex, admission and discharge dates, as well as data regarding the Braden scale assessment at the moment of admission, during the stay in the ICU and at discharge. Results: The study included 23 patients. 20 patients had pressure ulcer risk as assessed by the Braden scale. For 8 patients, a nursing care plan for “high risk of pressure ulcers” was written and interventions were conducted that showed very good harmonization with the parameters of the Braden scale. Croat Nurs J. 2017 ; 1(1): 5-14 The Harmonization of Braden Scale Assessments with Planned Interventions in Pressure Ulcer Prevention 6 Režić S. et al. The Harmonization of Braden Scale Assessments with Planned Interventions in Pressure Ulcer Prevention. Croat Nurs J. 2017 ; 1(1): 5-14 there were 23 patients in the Respiratory Intensive Care Unit – 15 were male and 8 female. The average age of the patients was 54.8 (36-84 years of age). The average bed days amounted to 9.86 days (ranging from 1 to 21 days). For every patient, a Braden scale assessment was made at admission as well as daily during their stay on the ward as part of the nursing documentation. The Braden scale assessment was done by nurses in charge of the patient, whereas the nursing care plan was done by the shift manager or the ward’s head nurse. For this purpose, a form was created which contained the admission and discharge dates, as well as data regarding the Braden scale assessment at the moment of admission, during the stay in the Respiratory Intensive Care Unit (RICU) and at discharge. Using the form, the point score was monitored for every patient according to every parameter of the Braden scale in order to determine the margin point score and the need for interventions that would arise from that. Results Of the 23 patients hospitalized in the RICU during the month-long study, 20 had a risk of sustaining pressure ulcers at admission and during their stay in the RICU. None of the patients admitted in the RICU during the study have previously had pressure ulcers. Table 1 shows the point score for the 23 patients hospitalized in the RICU. The table shows the number of patients admitted during that time, distributed according to the parameters of the Braden scale, with the assessment done at patient admission. It also shows the average number of bed days for the aforementioned number of patients, as well as any changes in the point score of the Braden scale during their stay on the ward. The table also shows for which patient group the nursing care plan was made. 8 patients had a written plan for “high risk of pressure ulcers”. For those patients, interventions aimed at preventing pressure ulcers were performed during the whole time of their hospitalization in the RICU. This amounts to 117 days of interventions in pressure ulcer prevention. It was noted that these patients had a score of 12 points or less, i.e. these patients were assessed as having “high risk” or “very high risk” on the Braden scale. For patients with an Conclusion: Although the Braden scale is a pressure ulcer risk assessment tool, the study shows broader application possibilities. This refers to the possibility of using the parameters of the Braden scale as guidance for choosing interventions

the Braden scale ; pressure ulcer prevention ; nursing care plan ; the algorithm of interventions for the treatment of pressure ulcers

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