The Braden Scale: An Easy Approach to the Assessment of the Bariatric Patient

The Braden Scale is a universally accepted assessment tool used to determine the at-risk status of patients for the development of skin breakdown issues, primarily pressure ulcers. Often nurses approach this task as one more “thing” to add to the list of daily duties. The Braden Scale is actually the accumulation of collected data which we as nurses process every day. The scale helps us put into numbers our ongoing observations.

The scale assesses six areas of concern. The clinician is guided by a set of questions which allows us to assign a point value to the subscale. Once all responses are completed and the values compiled, the final total indicates the at-risk level of the patient. Initially, interventions were based on the total score.  More recently emphasis has been placed on applying prevention and treatment measures based on the identified area of need. When assessing the bariatric patient, the clinician needs more specific information than that obtained by using standard observations as outlined in the traditional Braden Scale. Armed with the questions, the clinician can obtain a more accurate evaluation of the at-risk status of the bariatric patient and implement the most appropriate interventions for the prevention and/or treatment of pressure ulcers in this patient population.

When we learn to incorporate our routine observations, we will understand how the Braden Scale is an invaluable and simple method for the prevention of pressure ulcers. We will no longer regard the Braden Scale as a task but a source of information about the skin risk status of our patients and the appropriate interventions to insure healthy, intact skin.  We will be better equipped to provide the highest level of nursing care in our bariatric patient population.