Exploring the Braden QD Scale Assessment Performance and Related Hospital-Acquired Pressure Injury Influencing Factors among Critically Ill Adult Patients.

Abstract

Objective: To investigate the performance of the Braden QD Scale in predicting hospital-acquired pressure injuries (HAPIs) in critically ill adult patients and the incidence and factors associated with HAPIs within such patients.

Methods: A prospective observational study was conducted in a dual-center comprehensive ICU from June to September 2023. The nurse on duty examined all patients for skin integrity upon admission to the ICU and also scored patients using both the Braden and Braden QD scales. A patient's skin was then checked daily by 14 course-trained nurses until the patient was discharged or transferred out of the ICU. If a suspected HAPI was found, photographs were taken and sent to specialist nurses for confirmation and documentation.

Results: A total of 316 critically ill patients were enrolled in the study, and 79 HAPIs occurred. Fifty-five patients (17.4%) had pressure injuries (PIs), 35 patients (11.1%) had medical device-related PIs, and 14 patients (4.4%) had both medical device-related PIs and PIs. Essential predictors of HAPIs were detected. Further, the Braden QD Scale performed better than the Braden Scale in predicting HAPI development in critically ill adults, with the area under the curve being 0.77 (CI, 0.75-0.84) on admission.

Conclusions: The incidence of HAPIs in critically ill adult patients is high, with several influencing factors. The Braden QD Scale emerges as a validated predictive tool for HAPIs in critically ill adult patients, demonstrating clinical utility that warrants additional investigation to optimize prevention strategies.