The Braden Scale for Predicting Pressure Ulcer Risk is a widely adopted assessment tool used by healthcare professionals to determine an individual’s susceptibility to developing pressure injuries, often called bedsores. This evidence-based instrument helps in the early identification of at-risk patients, allowing for preventative care measures to be implemented before skin breakdown occurs. Understanding the scale’s calculation process provides insight into the factors that influence skin health during periods of limited mobility. This assessment is administered upon admission to a care facility and repeated regularly to monitor any changes in a patient’s condition.
The Six Domains of Assessment
The calculation of the Braden Score begins with the evaluation of six specific factors that contribute to the formation of pressure injuries. These six categories represent the building blocks of the assessment, each measuring a different aspect of a patient’s physical state and environment. The domains are Sensory Perception, which addresses the ability to feel and respond to discomfort; Moisture, which assesses the degree to which skin is exposed to wetness; and Activity, which measures the level of physical movement.
The assessment continues with Mobility, focusing on the ability to change and control body position independently, and Nutrition, which evaluates the patient’s usual food intake pattern. The final factor is Friction and Shear, which measures the risk of skin damage caused by sliding against surfaces. The total score is a sum of the numerical ratings assigned to each of these six domains.
Detailed Scoring Criteria for Each Domain
The core of the Braden Scale calculation involves assigning a numerical score to each of the six domains based on specific, descriptive criteria. For five of the six categories—Sensory Perception, Moisture, Activity, Mobility, and Nutrition—the scoring uses a scale from 1 to 4. A score of 4 indicates the highest level of functioning or the least amount of risk, while a score of 1 represents the most limited function and the highest risk for skin injury. This inverse relationship means that a lower score consistently indicates a higher level of concern within that specific factor.
For example, in the Sensory Perception domain, a score of 1 is assigned if the patient is “Completely Limited,” meaning they are unresponsive to painful stimuli. A score of 4 is given for “No Impairment,” indicating a full ability to feel and respond to discomfort. Similarly, the Mobility domain assigns a score of 1 for “Completely Immobile” and a score of 4 for “No Limitation,” where the patient can make frequent and significant position changes without assistance.
A slightly different numerical scale is used for the final domain, Friction and Shear, which is scored from 1 to 3. A score of 1 is assigned if the patient presents a “Problem,” requiring moderate to maximum assistance and frequently sliding in bed or a chair. A score of 3 is given for “No Apparent Problem,” meaning the patient moves independently and maintains a minimum of assistance.
Total Score Aggregation and Risk Interpretation
Once a score has been determined for all six categories, the final step is to aggregate these numbers to produce the overall Braden Score, which can range from 6 to 23. This total numerical value is then interpreted to determine the individual’s level of risk for developing a pressure injury. The lower the total score, the greater the probability of skin breakdown.
A score of 19 to 23 generally indicates no risk, but scores below this range warrant preventative action. A total score between 15 and 18 places the individual in the Mild Risk category. Individuals scoring 13 or 14 are considered to be at Moderate Risk, while a score from 10 to 12 signifies a High Risk. Any total score of 9 or less is categorized as Severe Risk, necessitating the most comprehensive care plan to preserve skin integrity. This final score serves as an objective guide for medical teams to tailor interventions, such as repositioning schedules, specialized mattresses, and nutritional support.