Bedsore risk factors

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Overview

Risk Factors

People at the highest risk for developing a Bedsore include:

  • Individuals who are bedridden
  • Individuals bound to a wheelchair
  • Malnourishment
  • Risk increases with age
  • Individuals with a injury or disease that may limit mobility (i.e. spinal cord injury)
  • Individuals with a condition that may inhibit blood flow to certain areas of the body (i.e. diabetes)
  • Individuals with urinary or bowel incontinence
  • Individuals with a mental condition that may affect mobility (i.e. Alzheimer's)

The Braden scale assesses a patient's risk of developing a pressure ulcer by examining six criteria: [1]

  1. Sensory Perception - This parameter measures a patient's ability to detect and respond to discomfort or pain that is related to pressure on parts of their body. The ability to sense pain itself plays into this category, as does a the level of consciousness of a patient and therefore their ability to cognitively react to pressure-related discomfort.
  2. Moisture - Excessive and continuous skin moisture can pose a risk to compromise the integrity of the skin by causing the skin tissue to become macerated and therefore be at risk for epidermal erosion. So this category assesses the degree of moisture the skin is exposed to.
  3. Activity - This category looks at a clients level of physical activity since very little or no activity can encourage atrophy of muscles and breakdown of tissue. [2]
  4. Mobility - This category looks at the capability of a client to adjust their body position independently. This assesses the physical competency to move and can involve the clients willingness to move.
  5. Nutrition - The assessment of a clients nutritional status looks at their normal patterns of daily nutrition. Eating only portions of meals or having imbalanced nutrition can indicate a high risk in this category.
  6. Friction and Shear - Friction and shear looks at the amount of assistance a client needs to move and the degree of sliding on beds of chairs that they experience. This category is assessed because the sliding motion can cause shear which means the skin and bone are moving in opposite directions causing breakdown of cell walls and capillaries.

Each category is rated on a scale of 1 to 4, except for the 'friction and shear' category which is rated on a 1-3 scale. This combines for a possible total of 23 points. A score of 23 means there is no risk for developing a pressure ulcer while the lowest possible score of 6 points represents the severest risk for developing a pressure ulcer.[3] An adult with a score below 18 is considered to have a high risk for developing a pressure ulcer.[4]

References

  1. Cassell, Charisse. "Pressure Ulcer Risk Assessment: The Braden Scale for Prediction Pressure Sore Risk." Health Services Advisory Group of California, Inc., n.d. Web. 25 Feb 2011. <http://www.hsag.com/App_Resources/Documents/CA_HSAG_LS3_Risk_Cassell.pdf>.
  2. http://cwx.prenhall.com/bookbind/pubbooks/martinidemo/chapter10/medialib/CH10/html/ch10_5_3.html
  3. Jiricka MK, Ryan P, Carvalho MA, Bukvich J (1995). "Pressure ulcer risk factors in an ICU population". Am. J. Crit. Care. 4 (5): 361–7. PMID 7489039.
  4. Folkedahl, B.A., & Frantz, R. (2002b). Treatment of pressure ulcers. Iowa City, IA: University of Iowa Gerontological Nursing Interventions Research Center, Research Dissemination Core

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