Abstract
The Braden Scale for Pressure Sore Risk© is a screening tool to determine overall risk of pressure ulcer development and estimate severity of specific risk factors for individual residents. Nurses often use the Braden nutrition subscale to screen nursing home (NH) residents for nutritional risk, and then recommend a more comprehensive nutritional assessment as indicated. Secondary data analysis from the Turn for Ulcer ReductioN (TURN) study’s investigation of U.S. and Canadian NH residents (n = 690) considered at moderate or high pressure ulcer (PrU) risk was used to evaluate the subscale’s utility for identifying nutritional intake risk factors. Associations were examined between Braden Nutritional Risk subscale screening, dietary intake (mean % meal intake and by meal timing, mean number of protein servings, protein sources, % intake of supplements and snacks), weight outcomes, and new PrU incidence. Of moderate and high PrU risk residents, 61.9% and 59.2% ate a mean meal % of <75. Fewer than 18% overall ate <50% of meals or refused meals. No significant differences were observed in weight differences by nutrition subscale risk or in mean number protein servings per meal (1.4 (SD = 0.58) versus 1.3 (SD = 0.53)) for moderate versus high PrU risk residents. The nutrition subscale approximates subsequent estimated dietary intake and can provide insight into meal intake patterns for those at either moderate or high PrU risk. Findings support the Braden Scale’s use as a preliminary screening method to identify focused areas for potential intervention.
Highlights
Compromised nutritional status has been linked to pressure ulcer (PrU) development for at least four decades, yet it remains an unresolved risk [1,2,3,4,5,6,7,8,9,10,11,12]
This paper focuses on nutritional risk based on the nutrition subscale, one of the Braden Scale’s six domains used to assess rate overall PrU risk
Short stay residents are likely different than long stay residents due to recent illnesses leading to transfer from hospital to nursing homes or substantial changes in condition requiring moving from home to nursing home; recent illness and relocation stress may influence dietary intake and inflammatory responses related to nutritional status [22]
Summary
Compromised nutritional status has been linked to pressure ulcer (PrU) development for at least four decades, yet it remains an unresolved risk [1,2,3,4,5,6,7,8,9,10,11,12]. Observational studies explored the relationship between factors, such as serum albumin, lower hemoglobin, lower dietary calories, and protein intake, with PrU incidence [1,2]. Few studies have prospectively observed dietary intake, nutritional risk status, and PrU development to draw conclusions about thresholds of overall intake related to PrU incidence and such studies are time and resource intense [5,6,7,8].
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