Evaluating the effects of using the mobility assessment sub-scale within the Braden Scale on pressure ulcer incidence and preventive interventions in adult acute care settings: A systematic review.

Abstract

Review objective The objective of this review is to establish whether using the Braden subscale mobility assessment is comparable to using the full Braden assessment scale. The specific review questions to be addressed are: 1. What preventive pressure ulcer nursing interventions are initiated based on assessment of mobility impairment alone or in comparison with the full Braden risk assessment scale? 2. What is the effect of using mobility assessment alone on incidence of hospital acquired pressure ulcers? Inclusion criteria Types of participants This review will consider studies that include adult patients, 18 years and older, in acute care setting who are at risk of developing pressure ulcers. At risk patients are those identified using Braden risk assessment scale as ‘at risk’, ‘moderate risk’, ‘high risk; and ‘very high risk’ for developing pressure ulcer6, 9 or the sub scale for impaired mobility as ‘completely immobile’, ‘very limited’ and ‘slightly limited’. Studies involving children only and studies conducted in the emergency department only or in the operating room only will be excluded from the review as they are not consistent with the review objective. Types of intervention(s)/Phenomena of interest This review will consider studies that include pressure ulcer risk identified using assessment of the subscale mobility impairment compared with full Braden scale assessment where available. Types of outcomes This review will consider the following primary outcome measures: • Whether patients in either study arm are more or less likely to receive appropriate preventative interventions, including, but not limited to protective mattresses, creams and skin barriers, vitamin supplements, patient positioning etc • Incidence of hospital acquired pressure ulcers Secondary outcome measures: • Reliability of mobility assessment ± Braden assessment • Frequency of assessment