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Braden Score: Case Studies 1 & 2

Braden Score: Case Studies 1 & 2. Case study # 1. 75-year-old male with Non-Hodgkins lymphoma, Alert and oriented Height 5’9”, Weight 160 lbs. Braden Score. Moisture 3. Braden Score. Activity 2. Braden Score. Nutrition 2. Braden Score. Friction/Shear 2. Braden Score.

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Braden Score: Case Studies 1 & 2

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  1. Braden Score: Case Studies 1 & 2

  2. Case study # 1 • 75-year-old male with Non-Hodgkins lymphoma, Alert and oriented • Height 5’9”, Weight 160 lbs.

  3. Braden Score • Moisture 3

  4. Braden Score • Activity 2

  5. Braden Score Nutrition 2

  6. Braden Score • Friction/Shear 2

  7. Braden Score Case Study # 2

  8. Case study #2 • Mrs. West is a 79- year old widowed female admitted to the nursing home after a right hip fracture. • She lives alone. Her daughter lives close by and visits frequently.

  9. Case study #2 • Past Medical History includes: • Hypertension • DM Type II insulin dependent • Anxiety Disorder • Osteoarthritis

  10. Case study #2 • During hospitalization: • Her anti-hypertension medications were restarted and adjusted. • After surgical hip pinning, PT and OT were ordered on the first day post-op for exercises, ROM, transfer, and ADL training. • She refused therapy due “I just don’t want to get out of bed yet”.

  11. Case study #2 Post-Op day 1 • PT reports that when she allows them to get her out of bed she requires assistance of two for safe transfers. OOB usually only once a day. Staff often find her slumped in the chair and have to put her back to bed.

  12. Case study #2 • She reports pain in right hip 5/10 and 2/10 in left knee from arthritis. • She is refusing any pain meds , “its too much trouble for those little girls, they are busy.”

  13. Case study #2 • She only consumes 50% of her food at each meal. She able to feed herself. • Her height and weight are: • 63 inches (5 foot ,3 inches) • 105 pounds

  14. Case study #2 • She is continent of urine but has occasionally has been found to be wet when staff have turned her.

  15. Case study #2 • Preferred position is supine with head of bed elevated with pillow under right leg.

  16. Case study #2 Post-Op day • Night shift nurse noted that there is a 1.0 CM X 2.0 cm non-blanchable reddened area on coccyx.

  17. Case study #2 Discharge Day • She is discharged to NH for PT/OT

  18. Braden Score What is the total score?

  19. Case study # 1 • Spends most of the day in bed. Makes occasional slight changes in body or extremity position but unable to make frequent or significant changes independently. • Occasionally slides down to foot of bed, requiring some assistance to move back to the top.

  20. Case Study: # 2 • Able to walk a short distance to the chair with assistance • Hgb = 8.5, Serum Albumin 3.1

  21. Case Study: # 2 • Incontinent of stool • Continent of urine – uses urinal as needed • Skin occasionally moist from incontinence

  22. Case Study # 2 • Admitting Orders: • Tube feeding formula 400cc q 4 hours per PEG • Dietician consult for tube feeding recommendations • Up in chair daily

  23. Case study # 2 Using the Braden Scale, what is Mr. W.G.’s sensory perception score? • 1 (Completely Limited) • 2 (Very Limited) • 3 (Slightly Limited) • 4 (No Impairment)

  24. Sensory Perception • 4 (No Impairment)

  25. Case study # 2 Using the Braden Scale, what is Mr. W.G.’s moisture score? • 1 (Constantly Moist) • 2 (Very Moist) • 3 (Occasionally Moist) • 4 (Rarely Moist)

  26. Moisture • 3 (Occasionally Moist)

  27. Case study # 2 Using the Braden Scale, what is Mr. W.G.’s activity score? • 1 (Bedfast) • 2 (Chairfast) • 3 (Walks Occasionally) • 4 (Walks Frequently)

  28. Activity • 2 (Chair fast)

  29. Using the Braden Scale, what is Mr. W.G.’s mobility score? • 1 (Completely Immobile) • 2 (Very Limited) • 3 (Slightly Limited) • 4 (No Limitations)

  30. Mobility score • 2 (Very Limited)

  31. Using the Braden Scale, what is Mr. W.G.’s nutrition score? • 1 (Very Poor) • 2 (Probably Inadequate) • 3 (Adequate) • 4 (Excellent)

  32. Nutrition • 3 (Adequate)

  33. Braden Score • Sensory 4

  34. Case study # 1 Using the Braden Scale, what is Mr. W.G.’s friction and shear score? • 1 (Problem) • 2 (Potential Problem) • 3 (No Apparent Problem)

  35. Friction and Shear • 2 (Potential Problem)

  36. Case study # 1 Based on Mr. W.G.’s total Braden Scale Score, indicate his level of risk for developing a pressure ulcer. • 9 or less = Very high risk • 10-12 = High risk • 13-14 = Moderate risk • 15-18 = Mild risk • 19-23 = Generally not at risk

  37. Based on Mr. W.G.’s total Braden Scale Score, indicate his level of risk for developing a pressure ulcer. • 9 or less = Very high risk • 10-12 = High risk • 13-14 = Moderate risk • 15-18 = Mild risk • 19-23 = Generally not at risk

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