Prevention of Pressure Ulcer using the Pressure Ulcer Risk Assessment Based on Braden Scale

Oh, Deuk Young; Kim, Jee Hoon; Lee, Paik Kwon; Ahn, Sang Tae; Rhie, Jong Won

Abstract

PURPOSE: Active prevention is an essential component in reducing the development of pressure sores. For the high-risk patient group, following the certified pressure sore screening scale as well as educating the patient and the nurses who care for them can lead to optimal management of these patients. Applying a risk assessment scale along with a prevention strategy can reduce medical costs and length of stays at the hospital. The purpose of this study is to evaluate the efficacy of a new pressure sore risk assessment scale based on the universally recommended Braden scale and our prevention program.
METHODS
From June to August, 2003, our pressure ulcer risk assessment scale was applied to a total of 1882 patients admitted to the experimental group (intensive care unit, neurosurgery, general surgery, and oncology units). It was based on Braden scale. We analysed sensitivity, specificity, positive and negative predictive value and ROC curve to evaluate its efficacy. Pressure ulcer prevention program was composed of patient's education using protocol and specific nursing care. The incidence of pressure ulcers was also measured during the 3 months period, and those were compared to the control group of 1789 patients from March to May, 2002.
RESULTS
118(6.27%) of the experimental group were high-risk with an incidence of pressure ulcers measuring 4 (0.21%). Sensitivity, specificity, positive and negative predictive value of our scale were 100%, 94%, 4%, 100%, respectively, and AUC(area under the curve) was 0.992. In the control group, the incidence of pressure ulcers was 11(0.61%). Statistical analyses using chi- squared tests with a significance level of 5%, the results were such that chi-square=3.6482(p=0.0561). The results proved to be statistically significant in borderline.
CONCLUSION
The results from this study proved that pressure sore risk assessment scale based on Braden scale has an excellent efficacy, and shows that our pressure ulcer prevention program is partially effective in reducing pressure ulcer incidence.