title: The effect of Web-based Braden Scale training on the reliability and precision of Braden Scale pressure ulcer risk assessments.
abstract: OBJECTIVE
  To evaluate the effect of Web-based Braden Scale training on the reliability and precision of pressure ulcer risk assessments made by registered nurses (RN) working in acute care settings.
  
  
  METHODS
  Pretest-posttest, 2-group, quasi-experimental design.
  
  
  METHODS
  Five hundred Braden Scale risk assessments were made on 102 acute care patients deemed to be at various levels of risk for pressure ulceration. Assessments were made by RNs working in acute care hospitals at 3 different medical centers where the Braden Scale was in regular daily use (2 medical centers) or new to the setting (1 medical center).
  
  
  METHODS
  The Braden Scale for Predicting Pressure Sore Risk was used to guide pressure ulcer risk assessments. A Web-based version of the Detroit Medical Center Braden Scale Computerized Training Module was used to teach nurses correct use of the Braden Scale and selection of risk-based pressure ulcer prevention interventions.
  
  
  RESULTS
  In the aggregate, RN generated reliable Braden Scale pressure ulcer risk assessments 65% of the time after training. The effect of Web-based Braden Scale training on reliability and precision of assessments varied according to familiarity with the scale. With training, new users of the scale made reliable assessments 84% of the time and significantly improved precision of their assessments. The reliability and precision of Braden Scale risk assessments made by its regular users was unaffected by training.
  
  
  CONCLUSIONS
  Technology-assisted Braden Scale training improved both reliability and precision of risk assessments made by new users of the scale, but had virtually no effect on the reliability or precision of risk assessments made by regular users of the instrument. Further research is needed to determine best approaches for improving reliability and precision of Braden Scale assessments made by its regular users.
authors.affiliation: School of Nursing, Oakland University, Rochester, Michigan, USA.
authors.forename: Morris A
authors.initials: MA
authors.lastname: Magnan
authors.forename: Joann
authors.initials: J
authors.lastname: Maklebust
mesh_terms: D016009:Chi-Square Distribution; D002983:Clinical Competence / Q000592:standards*; D003194:Computer-Assisted Instruction / Q000379:methods; D004509:Education, Nursing, Continuing / Q000458:organization & administration*; D006801:Humans; D020407:Internet / Q000458:organization & administration*; D008824:Michigan; D009730:Nursing Assessment / Q000592:standards*; D015402:Nursing Education Research; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000193:education*; D015588:Observer Variation; D003668:Pressure Ulcer / Q000209:etiology / Q000451:nursing* / Q000517:prevention & control; D015397:Program Evaluation; D018570:Risk Assessment / Q000592:standards