Curley MAQ, Hasbani NR, Quigley SM, Stellar JJ, Pasek TA, Shelley SS, Kulik LA, Chamblee TB, Dilloway MA, Caillouette CN, McCabe MA, Wypij D, et al.
The Journal of pediatrics. Date of publication 2018 Jan 1;volume 192():189-195.e2.
1. J Pediatr. 2018 Jan;192:189-195.e2. doi: 10.1016/j.jpeds.2017.09.045.
Predicting Pressure Injury Risk in Pediatric Patients: The Braden QD Scale.
Curley MAQ(1), Hasbani NR(2), Quigley SM(3), Stellar JJ(4), Pasek TA(5), Shelley
SS(6), Kulik LA(7), Chamblee TB(8), Dilloway MA(9), Caillouette CN(10), McCabe
MA(10), Wypij D(11).
Author information:
(1)Family and Community Health, School of Nursing, University of Pennsylvania,
Philadelphia, PA; Anesthesia and Critical Care Medicine, Perelman School of
Medicine, University of Pennsylvania, Philadelphia, PA; Critical Care and
Cardiovascular Nursing Program, Boston Children's Hospital, Boston, MA.
(2)Department of Cardiology, Boston Children's Hospital, Boston, MA.
(3)Surgical Nursing Program, Boston Children's Hospital, Boston, MA.
(4)Department of Nursing and General Surgery, The Children's Hospital of
Philadelphia, Philadelphia, PA.
(5)Pain/Pediatric Intensive Care Unit/Evidence-based Practice/Research,
Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center,
Pittsburgh, PA.
(6)Department of Nursing, Primary Children's Hospital, Salt Lake City, UT.
(7)Cardiovascular Nursing Patient Services, Boston Children's Hospital, Boston,
MA.
(8)Critical Care Services, Children's Medical Center Dallas, Dallas, TX.
(9)Patient Care Services, Rady Children's Hospital-San Diego, San Diego, CA.
(10)Surgical Programs, Boston Children's Hospital, Boston, MA; Medical Nursing
Program, Boston Children's Hospital, Boston, MA.
(11)Department of Cardiology, Boston Children's Hospital, Boston, MA; Department
of Pediatrics, Harvard Medical School, Boston, MA; Department of Biostatistics,
Harvard T.H. Chan School of Public Health, Boston, MA.
OBJECTIVE: To describe the development and initial testing of the Braden QD Scale
to predict both immobility-related and medical device-related pressure injury
risk in pediatric patients.
STUDY DESIGN: This was a multicenter, prospective cohort study enrolling
hospitalized patients, preterm to 21 years of age, on bedrest for at least 24
hours with a medical device in place. Receiver operating characteristic curves
using scores from the first observation day were used to characterize Braden QD
Scale performance, including areas under the curve (AUC) with 95% CIs.
RESULTS: Eight centers enrolled 625 patients. A total of 86 hospital-acquired
pressure injures were observed in 49 (8%) patients: 22 immobility-related
pressure injuries in 14 (2%) patients and 64 medical device-related pressure
injuries in 42 (7%) patients. The Braden QD Scale performed well in predicting
immobility-related and medical device-related pressure injuries in the overall
sample, with an AUC of 0.78 (95% CI 0.73-0.84). At a cutoff score of 13, the AUC
was 0.72 (95% CI 0.67-0.78), providing a sensitivity of 0.86 (95% CI 0.76-0.92),
specificity of 0.59 (95% CI 0.55-0.63), positive predictive value of 0.15 (95% CI
0.11-0.19), negative predictive value of 0.98 (95% CI 0.97-0.99), and a positive
likelihood ratio of 2.09 (95% CI 0.95-4.58).
CONCLUSIONS: The Braden QD Scale reliably predicts both immobility-related and
device-related pressure injuries in the pediatric acute care environment and will
be helpful in monitoring care and in guiding resource use in the prevention of
hospital-acquired pressure injuries.
Copyright © 2017 Elsevier Inc. All rights reserved.
DOI: 10.1016/j.jpeds.2017.09.045
PMID: 29246340 [Indexed for MEDLINE]
