Predicting pressure sore risk with the Norton, Braden, and Waterlow scales in a Hong Kong rehabilitation hospital.
BACKGROUND
Numerous pressure sore risk calculators have been developed since the 1960s. Each scale is claimed to have predictive value and applicability in various clinical settings, but it has not been determined which one is more relevant for adoption in a rehabilitation setting.


OBJECTIVE
To compare the predictive power of the three most commonly adopted pressure sore risk calculators: Norton, Braden, and Waterlow scales.


METHODS
One hundred six patients, free of pressure sores at admission, were assessed using the three scales by independent assessors within 48 hours of admission, followed by a daily monitoring of skin condition for at least 14 days to detect any sore that developed.


RESULTS
Both the Norton and Waterlow scales had relatively high sensitivity (81% and 95%, respectively), whereas the Braden Scale had both high sensitivity (91%) and specificity (62%). All three scales had relatively high negative predictive values (>90%), but the Braden Scale had better positive predictive value.


CONCLUSIONS
The Braden Scale is more suitable for use in a rehabilitation hospital.
Pang
S M
SM
Department of Nursing and Health Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon. hsspang@polyu.edu.hk
Wong
T K
TK
D000368:Aged; D000369:Aged, 80 and over; D015400:Clinical Nursing Research; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment / Q000379:methods* / Q000592:standards; D009737:Nursing Records; D003668:Pressure Ulcer / Q000209:etiology* / Q000451:nursing / Q000517:prevention & control; D012047:Rehabilitation Centers; D019145:Rehabilitation Nursing; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity