The WOCN Society 40th Annual Conference (June 21-25th, 2008)
The Effect of Web-based Braden Scale Training on the Reliability and Precision of Braden Scale Pressure Ulcer Risk Assessments
JoAnn Maklebust, MSN, APRN, BC, AOCN, FAAN, Karmanos Cancer Centrer, Clinical Nurse Specialist, 3100 John R, Detroit, MI 48201 and Morris A. Magnan, PhD, RN, At the time of this study, Dr Magnan was faculty at Oakland Uiversity School of Nursing, Assistant Professor, 86 Cherokee, Pontiac, MI 98341.
Abstract Objective: To evaluate the effect of web-based Braden Scale training on the reliability and precision of pressure ulcer risk assessments made by registered nurses working in acute care settings. Design: Pretest-posttest, two group, quasi-experimental design. Setting and Subjects: Five hundred Braden Scale risk assessments were made on 102 acute care patients deemed to be at various levels of risk for pressure ulceration. Assessments were made by registered nurses working in acute care hospitals at three separate medical centers where the Braden Scale was in regular daily use (2 medical centers) or new to the setting (1 medical center). Instrument: The Braden Scale for Predicting Pressure Sore Risk ® was used to guide pressure ulcer risk assessments. A web-based version of the Detroit Medical Center (DMC) Braden Scale Computerized Training Module® was used to teach nurses correct use of the Braden Scale and selection of risk-based pressure ulcer prevention interventions. Results: In the aggregate, registered nurses generated reliable Braden Scale pressure ulcer risk assessments 65% of the time after training. The effect of web-based Braden Scale training on reliability and precision of assessments varied according to familiarity with the Braden Scale. With training, new users of the Braden scale made reliable assessments 84% of the time and significantly improved precision of their assessments. The reliability and precision of Braden Scale risk assessments made by regular users of Braden Scale was unaffected by training. Conclusion: Technology-assisted Braden Scale training improved both reliability and precision of risk assessments made by new users of the Braden Scale but had virtually no effect on the reliability or precision of risk assessments made by regular users of the Braden Scale. Further research is needed to determine effective approaches for improving reliability and precision of Braden Scale assessments made by regular users of the Braden Scale.