title: Utility of Braden Scale Nutrition Subscale Ratings as an Indicator of Dietary Intake and Weight Outcomes among Nursing Home Residents at Risk for Pressure Ulcers.
abstract: The Braden Scale for Pressure Sore Risk(©) is a screening tool to determine overall risk of pressure ulcer development and estimate severity of specific risk factors for individual residents. Nurses often use the Braden nutrition subscale to screen nursing home (NH) residents for nutritional risk, and then recommend a more comprehensive nutritional assessment as indicated. Secondary data analysis from the Turn for Ulcer ReductioN (TURN) study's investigation of U.S. and Canadian NH residents (n = 690) considered at moderate or high pressure ulcer (PrU) risk was used to evaluate the subscale's utility for identifying nutritional intake risk factors. Associations were examined between Braden Nutritional Risk subscale screening, dietary intake (mean % meal intake and by meal timing, mean number of protein servings, protein sources, % intake of supplements and snacks), weight outcomes, and new PrU incidence. Of moderate and high PrU risk residents, 61.9% and 59.2% ate a mean meal % of <75. Fewer than 18% overall ate <50% of meals or refused meals. No significant differences were observed in weight differences by nutrition subscale risk or in mean number protein servings per meal (1.4 (SD = 0.58) versus 1.3 (SD = 0.53)) for moderate versus high PrU risk residents. The nutrition subscale approximates subsequent estimated dietary intake and can provide insight into meal intake patterns for those at either moderate or high PrU risk. Findings support the Braden Scale's use as a preliminary screening method to identify focused areas for potential intervention.
authors.affiliation: School of Nursing, University of North Carolina at Charlotte, Charlotte, NC 28223, USA. skenner2@uncc.edu.
authors.forename: Susan
authors.initials: S
authors.lastname: Kennerly
authors.affiliation: School of Nursing, UT Health Houston, Houston, TX 77030, USA. lisa.boss@uth.tmc.edu.
authors.forename: Lisa
authors.initials: L
authors.lastname: Boss
authors.affiliation: School of Nursing, Duke University, Durham, NC 27710, USA. tracey.yap@duke.edu.
authors.forename: Tracey L
authors.initials: TL
authors.lastname: Yap
authors.affiliation: School of Nursing, Duke University, Durham, NC 27710, USA. melissa.batchelor-murphy@dm.duke.edu.
authors.forename: Melissa
authors.initials: M
authors.lastname: Batchelor-Murphy
authors.affiliation: School of Medicine, University of Utah, Salt Lake City, UT 84108, USA. susan.horn@hsc.utah.edu.
authors.forename: Susan D
authors.initials: SD
authors.lastname: Horn
authors.affiliation: International Severity Information Systems and the Institute for Clinical Outcomes Research, Salt Lake City, UT 84102, USA. ryanscottbarrett@gmail.com.
authors.forename: Ryan
authors.initials: R
authors.lastname: Barrett
authors.affiliation: School of Nursing, UT Health Houston, Houston, TX 77030, USA. nancy.bergstrom@uth.tmc.edu.
authors.forename: Nancy
authors.initials: N
authors.lastname: Bergstrom
keywords: Braden Scale; TURN Study; nursing home; nutrition; nutritional risk; pressure ulcers