In the healthcare setting today decubitus ulcers (pressure sore) represent an ongoing challenge to health care professionals providing care to patients in different health-care settings. The incidence of decubitus ulcers estimates 1 to 3 million people in the United States each year. The National Pressure Ulcer Advisory Panel (NPUAP) defines prevalence as “a proportion of persons who have a pressure ulcer at a specific point in time.”Prevalence of pressure sores in the United States is widespread in all settings, with estimates of 10% to 18% in acute care, 2.3% to 28% in long-term care, and 0% to 29% in home care.
The burden of having a pressure ulcer is high, in physical, emotional, and financial terms. Data from 1999 indicate that the cost of treating pressure ulcers may range from $5 to $8.5 billion annually, and this equates to approximately $9.2 to $15.6 billion in 2008. The AHRQ reported that pressure ulcer-related hospitalizations ranged from 13 to 14 days and cost $16,755 to $20,430, compared with the average stay of 5 days and cost of approximately $10,000. The Centers for Medicare & Medicaid Services reports that the cost of treating a pressure ulcer in acute care (as a secondary diagnosis) is $43,180 per hospital stay. Contributing cost factors include increased length of stay because of pressure sore complications, such as pain, infection, high-tech support surfaces, and decreased functional ability.
Barbara Braden collaborated with Nancy Bergstrom in 1987 to develop Braden Scale for Predicting Pressure Ulcer Risk. The purpose of the scale is to help health professionals, especially nurses, to assess a patient’s risk of developing a pressure ulcer. In their study, the tool was tested in a multisite clinical trial involving hospitals, Veterans Administration (VA) medical centers and skilled nursing facilities. This research has proven to be effective in identifying and preventing pressure sores in high risk patient population. The Braden Scale is now the most widely tools used for predicting the risk of development of pressure sores. The Braden scale assesses a patient’s risk of developing a pressure ulcer by examining six criteria i.e. sensory perception, Moisture, Activity, Mobility, Nutrition and Friction and Shear. Based on the findings of the Braden scale strategies could be employed to prevent the development of pressure sores in high risk.