The short answer
The Braden Scale is a standard tool nurses use to estimate a resident's risk of developing a pressure injury (bedsore). It scores six factors: sensory perception, moisture, activity, mobility, nutrition, and friction and shear. Totals range from 6 to 23. Lower scores mean higher risk: generally 15 to 18 is mild risk, 13 to 14 moderate, 10 to 12 high and 9 or below very high.
The six factors
- Sensory perception: can the resident feel and report discomfort?
- Moisture: how often is the skin wet from sweat or incontinence?
- Activity: is the resident bedbound, chairbound or walking?
- Mobility: can the resident change position without help?
- Nutrition: how well is the resident eating?
- Friction and shear: does the resident slide down in bed or the chair?
What should happen when the score is low
A risk score is only useful if it leads to action. For an at-risk resident, the care plan should include specific prevention steps, such as a pressure-redistributing mattress, a turning and repositioning schedule, heel protection or "floating" heels on a pillow, prompt incontinence care, barrier creams, and a dietitian review.
What to ask
- What is the current Braden score, and what was it on admission?
- When was it last reassessed? (It should be redone regularly and after any change in condition.)
- What prevention steps were added when the score dropped?
A falling Braden score with no change in the care plan, followed by a new wound, is a common pattern in pressure injury neglect cases.
The rules behind this
- 42 C.F.R. § 483.25(b)(1) (pressure ulcers)
Related questions
This guide provides general information, not medical or legal advice. Rules change; confirm current requirements with the facility, the New York State Department of Health or a professional. Attorney Advertising.