Pressure ulcers are a serious risk for all bedridden patients, particularly the elderly. Ideally, assessing the patient's risk for developing pressure ulcers before the ulcers occur is the most effective way to mitigate risk. The quantitative analysis by Freitas & Alberti (2013) was designed to determine if one of the most commonly-used assessment tools, the Braden Scale, was a useful method of assessing a patient's risk for pressure ulcers in a home-based setting. The literature review of the article discusses the evolution of the scale which evaluates the patient based upon the following factors: the patient's sensory perception; levels of moisture; patient's activity level; patient mobility; ability to take nutrition; and finally, friction and shear on a scale from 1-5 for measures 1-4 and on friction and shear from 1-3 (Freitas & Alberti 2013). The lower the point value, the higher the risk of developing pressure ulcers. Some studies have indicated that patients in a home environment are often at particularly high risk (an estimated 70.2%) but the literature suggests that there is a need to further clarify the validity of the scale in home-based settings (Freitas & Alberti 2013). The study framework used was that of a prospective cohort study of 183 patients in a home-based setting in Brazil. The Braden Scale was used to evaluate the patients over the course of six monthly home visits for six months. Based upon the patient scores, the Braden scale was deemed to be effective in predicting pressure ulcers....

The incident rate of pressure ulcers in the study was 20% and patients with higher Braden Scale scores were more likely to develop them (Freitas & Alberti 2013). More women than men were involved in the program, as expected given women's grater longevity than men as a whole; no differences regarding patient race or other demographic information were found to affect results. The main impact was noted in terms of cognitive impairment: no patients with cognitive impairments developed pressure ulcers. This was again expected given the extent to which cognitive capacity can affect an individual's ability to move.
The sample size of the population was relatively limited, it should be noted, and the research design solely analyzed the effectiveness of the Braden Scale -- it did not determine, for example, if there was a more effective scale in existence which might have greater predictive value. The study was a prospective cohort study, however, and would likely be used to support further research in the future. Overall, the findings supported the utility of the Braden Scale as a measure of risk and the study designers suggested that it should be used as a way of determining risk for pressure ulcers through the use of more frequent evaluations of patients. The most controversial aspect of the article is the recommended frequency: the authors suggest using the scale on a monthly basis, as was used in the study. However, there is no specific evidence presented that using the scale more or less frequently is…