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Frequently
Asked Questions
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What
is the recommended frequency for using the Braden Scale on a routine
basis (other than when there is a sustained change in a patient's
condition)?
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The evidence
shows that admission assessment is not enough and that on-going
assessment improves the accuracy and the predictive ability of the
Braden Scale. The frequency of on-going assessments varies by clinical
area and the stability or liability of the patient population. While
a frequency of every 48 hours may be sufficient, many settings find
it difficult to achieve consistency in nursing practice with this
regimen. Consequently, most ICU's have adopted a policy of completing
a Braden Scale assessment every shift, while general Medical-Surgical
areas now complete a Braden Scale daily. We recommend that home
care nurses perform the assessment with each RN visit, as these
tend to correlate to skilled need patients. Nursing homes with skilled
designations should perform risk assessment on admission and weekly
thereafter. In nursing home with long-term patients, the assessment
should be done on admission, weekly for the first month, and monthly
thereafter.
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Can
we download an official copy of the Braden Scale?
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Yes,
you may access an official copy by clicking here.
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Is
the Braden Scale a skin assessment tool?
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No,
the Braden Scale is intended to assess risk for developing pressure
ulcers. Click here
for a suggested skin assessment tool.
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Our
flow sheet and admission form does not have space for the full Braden
Scale. Can we use an abbreviated form?
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It
is always best to use the long form of the Braden Scale. If you
do not use the entire Braden Scale on the chart, it is best to leave
on blank for the total score or a blank for each subscale score
and use no further descriptors. Copies of the complete Braden Scale
should be readily available and nurses should be directed to consult
the full Braden Scale to determine the value or number placed in
each of the blank spaces on the flow sheets.
Pocket
cards and large posters are available from MedPass. Click here
to go to our products information page.
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Our facility
is initiating electronic medical records. Can we use an abbreviated
version of the Braden Scale on this record?
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The
same answer given above applies to electronic records. However, it
is possible to build in the capacity to display each subscale with
full descriptions that appear when you "mouse over" the subscale title
in the electronic record, so nurses have access to the full description
before assigning a score.
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When
I look at different sites discussing the Braden Scale, some say low
risk is 15-16 and others say 18. Has this number changed over the
years?
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Yes, the correct
cut-off score is now considered to be 18 (See Bergstrom, et. al,
Nursing Research, 1998).
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How
do I get staff to use the Braden Scale effectively and score appropriately?
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If
you are implementing the Braden Scale for the first time in your facility,
you will need the endorsement and support of the administration. Nurses
should participate in in-service education related to the Braden Scale,
its routine use and facility-specific protocols. Our Web site offers
a number of in-service education tools. These include a video
that details each subscale of the Braden Scale and how to score these
subscales. In addition, we offer a CD,
"Using the Braden Scale in Clinical Practice" that provides 11 detailed
case studies and tests the competency of the nurse in determining
a Braden Scale score and applying appropriate nursing interventions
to each case. The CNA video teaches CNA's to recognize who is likely
to get a pressure ulcer and how they can contribute to prevention.
This video is very popular with long-term
care settings.
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Is there
a special Braden Scale for long-term care?
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The
Braden Scale has been tested for many settings, including long-term
care. There is no special version for long-term care. The one you
see on the Web site should be correct for all settings?
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The
protocols for the Braden Scale state that if the patient has advanced
age then you advance to the next level of risk. Is there a definition
of advanced age?
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In our studies,
patients over age 75 or 80 were more prone to developing pressure
ulcers. People and skin age at different rates, however, and younger
patients can also have frail skin that places them at higher risk.
Nursing judgment is essential to determining if an adjustment in
level of risk is necessary.
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Does
the Braden Scale apply to the pediatric population?
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The
Braden Scale has not been specifically tested in patients under the
age of 18. However, the Braden Q developed by Martha Curley and associates
was developed for younger children and has been tested in the pediatric
ICU population.
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If
our facility uses the Briggs version of the Braden Scale does that
mean we automatically have permission to use the Braden Scale?
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No.
Each facility that chooses to use the Braden Scale must obtain permission
to use the Braden Scale by filling out the permission request form
on our Web site.
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