Abstract: The NEW Braden QD Scale for Predicting Pediatric Pressure Injury Risk (50th Annual Conference)

Sunday, June 3, 2018: 2:45 PM

Martha A. Q. Curley, RN, PhD, FAAN, University of Pennsylvania, School of Nursing, Perelman School of Medicine, Philadelphia, PA, Natalie Hasbani, MPH, Cardiology, Boston Children's Hospital, Boston, MA, Sandy Quigley, RN, MSN, CWOCN, CPNP, Boston Children's Hospital, Boston, MA, Judith J. Stellar, MSN, CRNP, PPCNP-BC, CWOCN, Nursing & General Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA, Tracy A. Pasek, RN, DNP, CCNS, CCRN, CIMI, Children's Hospital of Pittsburgh, Pittsburgh, PA, Stacey Shelley, RN, MSN, MBA-HCM, Wound/Ostomy, Intermountain Healthcare, SLC, UT, Lindyce Kulik, MS, RN, CWON, CCRN, Cardiovascular Critical Care, Boston Children's Hospital, Boston, MA, Tracy B. Chamblee, PhD, APRN, PCNS-BC, CPPS, Quality and Patient Safety, Children's Health, Dallas, Dallas, TX, Mary Anne Dilloway, RN, PHN, BS, CWOCN, Rady Children's Hospital, San Diego, CA, Catherine Noonan Caillouette, RN, MS, CPNP, CWON, Department of Plastic & Oral Surgery, Boston Children's Hospital, Boston, MA, Margaret McCabe, PhD, RN, PNP, Nursing Research, Boston Children's Hospital, Boston, MA and David Wypij, PhD, Harvard T.H. Chan School of Public Health, Boston Children's Hospital, Harvard Medical School, Boston, MA

Purpose: Pressure injury prevention in hospitalized infants and children requires accurate identification of patient risk. Here we describe the development and initial testing of the Braden QD Scale that predicts both immobility-related and medical device-related pressure injury risk in hospitalized pediatric patients.

Methods: Multicenter prospective cohort study enrolling patients, preterm to 21 years of age, on bedrest for at least 24 hours with a medical device in place. Two nursing teams, working separately, evaluated patients up to 3 times per week. One team assessed patient risk for pressure-related injuries while the other completed skin assessments searching for pressure-related injuries.

Statistics: 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. We observed a total of 86 hospital-acquired pressure injures in 49 (8%) patients; specifically, 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 both immobility-related and medical device-related pressure injuries in the overall sample with an AUC of 0.78 (95% CI, 0.73-0.84) and in age, diagnosis, and intubation subgroups. With a cutoff score of 13, the new Braden QD Scale provides comparable sensitivity and specificity to that previously reported with the Braden Q Scale but now predicts both immobility-related and medical device-related pressure injuries in hospitalized pediatric patients across the age continuum.

Conclusions: The new Braden QD provides a conceptually-based, pediatric-specific, risk assessment instrument that reliably predicts immobility-related and medical device-related pressure injuries in the pediatric acute care environment. The instrument will be helpful in preventing hospital-acquired pressure injuries, aid in the quality monitoring of care, and help guide resource use in pediatric patients.

Accepted for publication: J Pediatr

GS03 The NEW Braden QD Scale for Predicting Pediatric Pressure Injury Risk