Braden Score: Case Studies 1

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Braden Score Case Studies 1 2
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Case study 1

• 75-year-old male with Non-Hodgkins lymphoma,
  Alert and oriented
• Height 59, Weight 160 lbs.

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Braden Score

• Moisture 3

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Braden Score

• Activity 2

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Braden Score

• Nutrition 2

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Braden Score

• Friction/Shear 2

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Braden Score

• Case Study 2

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Case study 2

• Mrs. West is a 79- year old widowed female
  admitted to the nursing home after a right hip
  fracture.
• She lives alone. Her daughter lives close by and
  visits frequently.

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Case study 2

• Past Medical History includes
• Hypertension
• DM Type II insulin dependent
• Anxiety Disorder
• Osteoarthritis

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Case study 2

• During hospitalization
• Her anti-hypertension medications were restarted
  and adjusted.
• After surgical hip pinning, PT and OT were
  ordered on the first day post-op for exercises,
  ROM, transfer, and ADL training.
• She refused therapy due I just dont want to get
  out of bed yet.

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Case study 2

• Post-Op day 1
• PT reports that when she allows them to get her
  out of bed she requires assistance of two for
  safe transfers. OOB usually only once a day.
  Staff often find her slumped in the chair and
  have to put her back to bed.

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Case study 2

• She reports pain in right hip 5/10 and 2/10 in
  left knee from arthritis.
• She is refusing any pain meds , its too much
  trouble for those little girls, they are busy.

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Case study 2

• She only consumes 50 of her food at each meal.
  She able to feed herself.
• Her height and weight are
• 63 inches (5 foot ,3 inches)
• 105 pounds

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Case study 2

• She is continent of urine but has occasionally
  has been found to be wet when staff have turned
  her.

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Case study 2

• Preferred position is supine with head of bed
  elevated with pillow under right leg.

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Case study 2

• Post-Op day
• Night shift nurse noted that there is a 1.0 CM X
  2.0 cm non-blanchable reddened area on coccyx.

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Case study 2

• Discharge Day
• She is discharged to NH for PT/OT

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Braden Score

• What is the total score?

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Case study 1

• Spends most of the day in bed. Makes occasional
  slight changes in body or extremity position but
  unable to make frequent or significant changes
  independently.
• Occasionally slides down to foot of bed,
  requiring some assistance to move back to the
  top.

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Case Study 2

• Able to walk a short distance to the chair with
  assistance
• Hgb 8.5, Serum Albumin 3.1

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Case Study 2

• Incontinent of stool
• Continent of urine uses urinal as needed
• Skin occasionally moist from incontinence

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Case Study 2

• Admitting Orders
• Tube feeding formula 400cc q 4 hours per PEG
• Dietician consult for tube feeding
  recommendations
• Up in chair daily

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Case study 2

• Using the Braden Scale, what is Mr. W.G.s
  sensory perception score?
• 1 (Completely Limited)
• 2 (Very Limited)
• 3 (Slightly Limited)
• 4 (No Impairment)

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Sensory Perception

• 4 (No Impairment)

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Case study 2

• Using the Braden Scale, what is Mr. W.G.s
  moisture score?
• 1 (Constantly Moist)
• 2 (Very Moist)
• 3 (Occasionally Moist)
• 4 (Rarely Moist)

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Moisture

• 3 (Occasionally Moist)

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Case study 2

• Using the Braden Scale, what is Mr. W.G.s
  activity score?
• 1 (Bedfast)
• 2 (Chairfast)
• 3 (Walks Occasionally)
• 4 (Walks Frequently)

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Activity

• 2 (Chair fast)

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• Using the Braden Scale, what is Mr. W.G.s
  mobility score?
• 1 (Completely Immobile)
• 2 (Very Limited)
• 3 (Slightly Limited)
• 4 (No Limitations)

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Mobility score

• 2 (Very Limited)

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• Using the Braden Scale, what is Mr. W.G.s
  nutrition score?
• 1 (Very Poor)
• 2 (Probably Inadequate)
• 3 (Adequate)
• 4 (Excellent)

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Nutrition

• 3 (Adequate)

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Braden Score

• Sensory 4

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Case study 1

• Using the Braden Scale, what is Mr. W.G.s
  friction and shear score?
• 1 (Problem)
• 2 (Potential Problem)
• 3 (No Apparent Problem)

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Friction and Shear

• 2 (Potential Problem)

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Case study 1

• Based on Mr. W.G.s total Braden Scale Score,
  indicate his level of risk for developing a
  pressure ulcer.
• 9 or less Very high risk
• 10-12 High risk
• 13-14 Moderate risk
• 15-18 Mild risk
• 19-23 Generally not at risk

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• Based on Mr. W.G.s total Braden Scale Score,
  indicate his level of risk for developing a
  pressure ulcer.
• 9 or less Very high risk
• 10-12 High risk
• 13-14 Moderate risk
• 15-18 Mild risk
• 19-23 Generally not at risk