title: Predicting Pressure Ulcer Development in Clinical Practice: Evaluation of Braden Scale Scores and Nutrition Parameters.
abstract: OBJECTIVE
  Accurate patient assessment and screening for pressure ulcer (PU) is difficult in the clinical setting, and evaluation of nutritional status is especially problematic. The aim of this retrospective study was to determine the extent to which Braden Scale scores and other nutrition screening parameters (body mass index, poor intake, and weight loss) predict PU development in general and heel and sacral ulcers specifically.
  
  
  METHODS
  Records of 230 hospitalized patients who developed PU were compared to a matched control group without PU. Logistic regression was used to determine the association of total Braden scores, Braden nutrition subscale scores, and nutrition factors with PU development at any time, within week 1, or within week 2 of hospitalization; and development of sacral and heel ulcers at these same periods.
  
  
  RESULTS
  Braden Scale scores on hospital admission were predictive of hospital-acquired pressure ulcer development at some point during the hospital stay; and more specifically Braden scores on day 7 were predictive of PU development within week 2 of hospitalization. Among nutrition screening factors and PU development, a low body mass index showed a statistically significant relationship with sacral ulcer development.
  
  
  CONCLUSIONS
  Findings indicate that the overall Braden score is a valid predictor of PU development. Implications for clinical practice to decrease the risk for PU development include appropriate use of reliable and valid scales by nurses along with careful evaluation of nutrition parameters.
authors.affiliation: Natasha Miller, MSN, RN, CCRN, CWOCN, Penn State Hershey Medical Center, Hershey, Pennsylvania. David Frankenfield, MS, RD, Penn State Hershey Medical Center, Hershey, Pennsylvania. Erik Lehman, MS, Department of Public Health Sciences, College of Medicine Penn State University, Hershey, Pennsylvania. Melissa Maguire, BSN, RN-BC, Penn State Hershey Medical Center, Hershey, Pennsylvania. Victoria Schirm, PhD, RN, Penn State Hershey Medical Center, Hershey, Pennsylvania.
authors.forename: Natasha
authors.initials: N
authors.lastname: Miller
authors.forename: David
authors.initials: D
authors.lastname: Frankenfield
authors.forename: Erik
authors.initials: E
authors.lastname: Lehman
authors.forename: Melissa
authors.initials: M
authors.lastname: Maguire
authors.forename: Victoria
authors.initials: V
authors.lastname: Schirm
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002149:Energy Intake; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011237:Predictive Value of Tests; D003668:Pressure Ulcer / Q000175:diagnosis* / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors