Heel Pressure Injury: Correlation of HPI and Braden Scale Score

Purpose: To establish a correlation with heel pressure injury (HPI) incidence and Braden Scale score in order to predict a patient’s risk of facility acquired HPI.
Method: At a level II rural hospital with an average inpatient daily census of 95, a retrospective study of facility acquired heel pressure injury was conducted. In a 2.8 year span, 14 heel pressure injuries (14 patients) were acquired. The Braden Scale and subscale was reviewed for total score at time of admission and time of pressure ulcer discovery.

Results: The average Braden score: admission 13.2, HPI 14. On admission risk was evenly divided between the high risk/ moderate risk group and the mild/ low risk group. At time of HPI, 58% were in the high risk to moderate risk group, 42% in the mild/ low risk group. On admission and time of HPI, all of the subscales showed significance. However, the highest risk subscales were activity (71%), mobility 100%, friction & shear 100%. This was also reflected in HPI group: activity (93%), mobility (100%), friction and shear (100%).

Conclusion: The study indicates that the Braden subscales are better indicator of risk for HPI than overall score. Deficits in activity, mobility, friction and shear increase risk of HPI. This study may also reflect the need for additional pressure injury prevention interventions as patient condition changes.