Registered Nurses Perception of Pressure Injury Risk Compared to the Electronic Pressure Injury Braden Scale Risk Assessment Score

Background: Registered Nurses utilize pressure injury risk assessment tools to identify patients at risk of developing pressure related skin injury. Studies indicate that Registered Nurses tend to rely on their own knowledge and experience rather than evidence-based tools to manage the pressure injury risk to patients. The purpose of this study was to compare Registered Nurses perception/subjective assessment of a newly admitted patient’s (first 24 hours) risk for pressure injury to the objective assessment of an electronic risk assessment tool, specifically the Braden Scale.

Methodology: This was a descriptive correlational study in which Registered Nurses were asked whether the newly admitted patient may be at risk for pressure injury and why.  The Registered Nurses then scored patients according to the Braden Scale. The sample included all newly admitted adult patients 18 years or older, on three medical-surgical units over a three week period. Medical history and demographic information were also collected.

Results: There were 135 data pairs that met the inclusion criteria. A Chi-square test of independence was performed, with results indicating that an association exists between the results of the RN’s assessment and the Braden Scale. Additionally, t-test comparisons of the sample were conducted related to age, gender, length of stay and related conditions (e.g. diabetes, incontinence, and immobility). These additional demographic analyses, as well as analyses of nurse’s reasons for ‘at risk’ assessment, and the impact of behavioral elements will be discussed.

Implications for Practice and Research: The literature has shown that nurses have knowledge of pressure injury risk; however, injuries still occur. Validated pressure injury risk assessment tools may need to be updated to incorporate and weigh the impact of additional parameters that more accurately identify the score for a patient and provide meaningful practice recommendations.