All comments entered into the data collection form were collated and reviewed by the Task Force. Respondents' comments reflected concern about: 1) exclusive use of the Braden Scale for pressure ulcer risk assessment and the limited number of comorbid conditions listed for consideration; 2) the need to provide definitions for each of the categories of support surfaces, particularly Australian Medical-grade sheepskin, as well as a desire for inclusion of examples of support surfaces in each category; 3) the desire to provide more specific guidance with regard to support surface recommendations; 4) possible inclusion of patient preference as a consideration for support surface selection; and 5) a desire to compress the algorithm presented during the conference for efficiency and ease of use. In a few instances, respondents felt that instructions for the user to “consider” use of a support surface were too soft and should be replaced with “should.” Modifications to were made to the algorithm's wording to improve clarity or appropriateness based on this qualitative feedback.
The relative contributions of the cumulative Braden scale score, subscale scores, clinical judgment and experience in clinical decision-making are not known. Magnan & Maklebust44 evaluated relationships between Braden subscale scores and nurses' selection of 10 commonly used pressure ulcer preventive interventions. Findings suggest that subscale scores influence nurses' endorsement of various preventive interventions in 2 ways; participants used unique combinations of subscale scores to assess risk, and they were more likely to implement preventive interventions as these scores decreased and risk increased. Additional research is needed to determine the efficacy of preventive strategies based on Braden Scale subscores alone or in combination.
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