Predicting the risk of pressure ulcers in critically ill patients.
BACKGROUND
Critically ill patients are at high risk for pressure ulcers.


OBJECTIVE
To determine the contributions of the Braden subscales in predicting pressure ulcers in critically ill patients and to investigate how often the Braden scale should be completed to assess the risk for pressure ulcers in critically ill patients.


METHODS
The Braden scale was used to assess repeatedly 136 adult patients without pressure ulcers in a medical intensive care unit, a surgical intensive care unit, and a noninvasive respiratory care unit, and the patients' skin was inspected routinely for pressure ulcers.


RESULTS
A total of 36 pressure ulcers, most commonly on the sacrum or coccyx and the heels (15 stage 1, 20 stage 2, 1 stage 3), developed in 17 patients (12%). In 14 (82%) of the 17, the ulcers developed within 72 hours of admission to the intensive care unit. The risk for pressure ulcers increased as the mean sensory perception (P = .01) and the mean total Braden (P = .046) scores decreased. The mean sensory perception scores obtained at 12 and 36 hours after admission also had a significant relationship to the risk for pressure ulcers (P = .03).


CONCLUSIONS
Patients in intensive care units have an increased risk for pressure ulcers. Although waiting until 12 hours after a patient's admission to the intensive care unit to obtain the initial Braden rating may be reasonable (with the second rating obtained 36 hours after admission), additional research is needed before this practice can be recommended.
Rush University College of Nursing, Chicago, IL, USA.
E V
EV
Carlson
M G
MG
Kemp
S
S
Shott
D018806:APACHE; D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015400:Clinical Nursing Research; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness; D005260:Female; D006801:Humans; D006813:Humidity; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment / Q000379:methods*; D009752:Nutritional Status; D011237:Predictive Value of Tests; D011312:Pressure; D003668:Pressure Ulcer / Q000209:etiology* / Q000451:nursing*; D011446:Prospective Studies; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012677:Sensation; D013997:Time Factors; D014481:United States