PURPOSE
This methodological study was conducted to evaluate the interrater agreement in pressure ulcer risk assessment using the Braden scale, and in pressure ulcer classification, by nurses in a medium-sized hospital.
METHODS
Data were collected from a medium-sized hospital, located in Seoul, from December 18, 2017 to February 28, 2018. The author (Rater 1) and 20 randomly sampled nurses (Rater 2) independently assessed 100 patients. The Braden scale for risk assessment and the six-stage pressure ulcer classification system were used. The interrater agreement was evaluated using the Intraclass Correlation Coefficient (ICC), the proportion of agreement (Po), and the Bland-Altman plots.
RESULTS
For the total score on the Braden scale, the ICC was .85 and the Po was .29. Among the scale items, ‘moisture’ had the lowest agreement (ICC=.55, Po=.46). The interrater agreement had Po values of .84 and .69 for the presence and the classification of pressure ulcers, respectively.
CONCLUSION
For nurses in medium-sized hospitals, interrater agreement for the Braden scale and for the classification of pressure ulcers should be enhanced. In order to do this, overall institutional support is needed, including training in the accurate use of tools for pressure ulcer care.

Citations

• Impact of multifaceted interventions on pressure injury prevention: a systematic review
  Usha Rani Kandula
  BMC Nursing.2025;[Epub]     CrossRef
• Development of a Pressure Injury Machine Learning Prediction Model and Integration into Clinical Practice: A Prediction Model Development and Validation Study
  Ju Hee Lee, Jae Yong Yu, So Yun Shim, Kyung Mi Yeom, Hyun A Ha, Se Yong Jekal, Ki Tae Moon, Joo Hee Park, Sook Hyun Park, Jeong Hee Hong, Mi Ra Song, Won Chul Cha
  Korean Journal of Adult Nursing.2024; 36(3): 191.     CrossRef
• Determining Optimal Cut-off Score for the Braden Scale on Assessment of Pressure Injury for Tertiary Hospital Inpatients
  Sook Hyun Park, hyeyeon Choi, Youn-Jung Son
  Journal of Korean Critical Care Nursing.2023; 16(3): 24.     CrossRef
• Impact of Pressure Injury Prevention Protocol in Home Care Services on the Prevalence of Pressure Injuries in the Dubai Community
  Sajitha Prasad, Nazneen Hussain, Sangeeta Sharma, Somy Chandy, Jessy Kurien
  Dubai Medical Journal.2020; 3(3): 99.     CrossRef

PURPOSE
The purpose of this study was to evaluate the applicability of braden scale to assess pressure ulcer risk patients and to identify additional risk factors of pressure sores in an neurologic intensive care unit.
METHOD
The subjects of this study were 66 patients in neurologic intensive care units. Data was prospectively collected from Sep. to Dec., 2002. Data were analyzed by mean, percentage, t-test, chi-square, discriminant analysis using Spss pc+.
RESULT
The results of this study were as follows: 1) There was a significant difference between scoring of braden scale and pressure ulcer development. The subscales that predicted pressure ulcer development using braden scale only were sensory perception, moisture, mobility, friction and shear. By using these subscales, sensitivity was 86.7%, and specificity was 61.1%, and total hit ratio was 72.7%. 2) Additional pressure ulcer risk factors which showed significance for discriminating two group were protein, albumin, gender, level of consciousness, pattern of bowel elimination. By using the combination of these additional risk factors in addition to the braden scale, total hit ratio increased to 84.8%.
CONCLUSION
This data suggest that albumin, protein, gender, level of consciousness, pattern of bowel elimination in addition to the braden scale should be included in the pressure sore assessment tool.