Curley MA, Razmus IS, Roberts KE, Wypij D, et al.
Nursing research. Date of publication 2003 Jan 1;volume 52(1):22-33.
1. Nurs Res. 2003 Jan-Feb;52(1):22-33.
Predicting pressure ulcer risk in pediatric patients: the Braden Q Scale.
Curley MA(1), Razmus IS, Roberts KE, Wypij D.
Author information:
(1)Critical Care and Cardiovascular Nursing Research, Children's Hospital,
Boston, Massachusetts 02115, USA. Martha.Curley@TCH.Harvard.edu
BACKGROUND: While there are valid and reliable pressure ulcer risk assessment
tools available for adult patients, none exist for infants and children. To
remedy this, the Braden Scale was adapted for use in pediatrics, calling it the
Braden Q Scale.
OBJECTIVE: The purpose of this study was to: (a) establish the predictive
validity of the Braden Q Scale in an acutely ill pediatric population; (b)
determine the critical cutoff point for classifying patient risk; and (c)
determine the best time to assess patient risk.
METHODS: A multisite prospective cohort descriptive study with a convenience
sample of 322 patients on bedrest for at least 24 hours without pre-existing
pressure ulcers or congenital heart disease were enrolled from three pediatric
intensive care units (PICU). The Braden Q score and skin assessment were
independently rated and data collectors were blind to the other measures.
Patients were observed up to 3 times per week for 2 weeks and then once a week
until PICU discharge for a median of 2 observations reflecting 887 skin
assessments.
RESULTS: Eighty-six patients (27%) developed 199 pressure ulcers; 139 (70%) were
Stage I pressure ulcers, 54 (27%) were Stage II pressure ulcers, and 6 (3%) were
Stage III pressure ulcers. Most pressure ulcers (57%) were present at the first
observation. Using Stage II+ pressure ulcer data obtained during the first
observation, a Receiver Operator Characteristic (ROC) curve for each possible
score of the Braden Q Scale was constructed. The area under the curve (AUC) was
0.83. At a cutoff score of 16, the sensitivity was 0.88 and the specificity was
0.58. The Braden Q Scale was then modified to eliminate 4 subscales with an AUC
<0.7. With 3 subscales (mobility, sensory perception, tissue
perfusion/oxygenation) the AUC of this Modified Braden Q Scale was maintained at
0.84. At a cutoff score of 7, the sensitivity was 0.92 and the specificity was
0.59.
CONCLUSIONS: The performance of the Braden Q Scale in a pediatric population is
similar to that consistently reported for the Braden Scale in adult patients. The
Modified Braden Q Scale, with 3 subscales, provides a shorter yet comparable
tool.
PMID: 12552172 [Indexed for MEDLINE]
