title: Pressure ulcer risk assessment: retrospective analysis of Braden Scale scores in Portuguese hospitalised adult patients.
abstract: OBJECTIVE
  To analyse the Braden Scale scores and sub-scores assessed in Portuguese hospitalised adult patients in association with their characteristics, diagnoses and length of stay.
  
  
  BACKGROUND
  The Braden Scale is used worldwide for pressure ulcer risk assessment and supports nurses in the implementation of preventive interventions.
  
  
  METHODS
  Retrospective cohort analysis of electronic health record database from adult patients admitted to medical and surgical areas during 2012.
  
  
  METHODS
  Braden Scale scores and sub-scores of 8147 patients were associated with age, gender, type of admission (emergency service or programmed), specialty units (medical or surgical), length of stay, patient discharge (discharge, decease or transference to other hospital) and ICD-9 diagnosis.
  
  
  RESULTS
  The participants with significantly lower Braden Scale scores were women, older people, hospitalised in medical units, with emergency service admission, longer hospitalisation stays and/or with vascular, traumatisms, respiratory, infection or cardiac diseases. Mobility, friction/shear forces and activity had higher contributions to the Braden Scale score, while nutrition had the lowest contribution.
  
  
  CONCLUSIONS
  Approximately one-third of all participants had high risk of pressure ulcer development at admission, which led to the application of nursing preventive care. Our study demonstrated that nurses should pay special attention to patients over 50 years of age, who had significantly lower Braden Scale scores. The Braden Scale scores significantly increased in the last assessments showing that Braden Scale is sensitive to the clinical improvement of the patient. Braden Scale correlations with length of stay reveal its importance as predictor of length of stay.
  
  
  CONCLUSIONS
  Nurses should use Braden Scale assessment and consider patients' characteristics and diagnoses to plan more focused preventive interventions and improve nursing care. This study could be the first step to create a preventive protocol based on institutional reality, patients' characteristics, level of risk and affected sub-scales.
authors: Instituto de Ciências Biomédicas Abel Salazar, University of Oporto, Portugal.|Centro Hospitalar do Baixo Vouga, Aveiro, Portugal.|School of Health Sciences, University of Aveiro, Portugal.
authors: Pedro
authors: P
authors: Sardo
authors: QOPNA, University of Aveiro, Portugal.
authors: Cláudia
authors: C
authors: Simões
authors: School of Health Sciences, University of Aveiro, Portugal.|University of Aveiro, Portugal.
authors: José
authors: J
authors: Alvarelhão
authors: Centro Hospitalar do Baixo Vouga, Aveiro, Portugal.|School of Health Sciences, University of Aveiro, Portugal.|University of Aveiro, Portugal.
authors: César
authors: C
authors: Costa
authors: Centro Hospitalar do Baixo Vouga, Aveiro, Portugal.|School of Health Sciences, University of Aveiro, Portugal.|University of Aveiro, Portugal.
authors: Carlos J
authors: CJ
authors: Simões
authors: Centro Hospitalar do Baixo Vouga, Aveiro, Portugal.
authors: Jorge
authors: J
authors: Figueira
authors: School of Health Sciences, University of Aveiro, Portugal.|CINTESIS, University of Oporto, Portugal.
authors: João L
authors: http://orcid.org/0000-0002-4989-2252
authors: JL
authors: Simões
authors: School of Health Sciences, University of Aveiro, Portugal.
authors: Francisco
authors: F
authors: Amado
authors: School of Health Sciences, University of Aveiro, Portugal.
authors: António
authors: A
authors: Amaro
authors: School of Health Sciences, University of Aveiro, Portugal.|CINTESIS, University of Oporto, Portugal.|CEISUC, University of Coimbra, Portugal.
authors: Elsa
authors: E
authors: Melo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment; D009752:Nutritional Status; D011174:Portugal; D003668:Pressure Ulcer / Q000451:nursing* / Q000517:prevention & control; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Branden Scale; clinical judgement; hospitalisation; nursing; nursing assessment; pressure ulcer; risk assessment