Psychometric properties of the Braden scale to assess pressure injury risk in intensive care : A systematic review.
Journal article
Mehicic, Aldiana, Burston, Adam Scott and Fulbrook, Paul Richard. (2024). Psychometric properties of the Braden scale to assess pressure injury risk in intensive care : A systematic review. Intensive and Critical Care Nursing. 83, pp. 1-11. https://doi.org/10.1016/j.iccn.2024.103686
Authors | Mehicic, Aldiana, Burston, Adam Scott and Fulbrook, Paul Richard |
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Abstract | Objective: To analyse the psychometric properties of the Braden scale to assess pressure injury risk in adults in intensive care. Design: A systematic review was conducted, with literature searches undertaken in five electronic databases. No date limits were applied. Selection, data extraction and risk of bias assessment were completed by two reviewers independently. A customised data extraction template was used, with risk of bias conducted using the COSMIN Risk of Bias checklist. Data were analysed using narrative synthesis. Results: Thirty-four studies met inclusion criteria. Two studies reported internal consistency with Cronbach’s alpha ranging from poor (0.43) to good (0.85). For interrater reliability, only four studies reported intraclass correlation, ranging from 0.66 to 0.96 for Braden sum score. Three studies reported convergent validity, with strong associations found between the COMHON Index (r = 0.70), Cubbin-Jackson scale (r = 0.80), and Norton scale (r = 0.77), but contrasting associations with the Waterlow score (r = 0.22 to 0.72). A large majority of studies reported predictive validity (n = 29), with wide variability. Several studies investigated optimal cut-off scores, with the majority indicating this was in the range of 12–14. Conclusions: This review demonstrates inconsistency in the psychometric properties of the Braden scale in ICU settings. Further research is needed to determine suitability of the Braden scale for ICU before it can be recommended as standard for clinical practice, including comparison with other ICU-specific risk assessment tools. Implications for clinical practice: When used in ICU, the reliability, validity and reported cut-off scores of the Braden scale are variable. As a predictive tool, the scale should be used cautiously. In ICU, the value of the Braden scale resides in its ability to identify patients that are most at risk of developing a pressure injury and to implement preventative measures to mitigate identified risk factors. |
Keywords | Braden scale Intensive care Pressure injury Risk assessment Systematic review |
Year | 01 Jan 2024 |
Journal | Intensive and Critical Care Nursing |
Journal citation | 83, pp. 1-11 |
Publisher | Elsevier Inc. (USA) |
ISSN | 1532-4036 |
Digital Object Identifier (DOI) | https://doi.org/10.1016/j.iccn.2024.103686 |
Web address (URL) | https://www.sciencedirect.com/science/article/pii/S0964339724000661?via%3Dihub |
Open access | Open access |
Research or scholarly | Research |
Page range | 1-11 |
Publisher's version | License File Access Level Open |
Output status | Published |
Publication dates | |
22 Mar 2024 | |
Publication process dates | |
Accepted | 13 Mar 2024 |
Deposited | 30 Aug 2024 |
Additional information | © 2024 The Author(s). Published by Elsevier Ltd. |
This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). | |
Place of publication | Australia |
https://acuresearchbank.acu.edu.au/item/90x6x/psychometric-properties-of-the-braden-scale-to-assess-pressure-injury-risk-in-intensive-care-a-systematic-review
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Publisher's version
OA_Mehicic_2024_Psychometric_properties_of_the_Braden_scale.pdf | |
License: CC BY 4.0 | |
File access level: Open |
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