Title

Predicting Pressure Injury Risk in Pediatric Patients: The Braden QD Scale.

Authors

Martha A Q Curley, Children's Hospital of Philadelphia, Philadelphia, PAFollow
Natalie R Hasbani
Sandy M Quigley
Judith J Stellar
Tracy A Pasek
Stacey S Shelley
Lindyce A Kulik
Tracy B Chamblee
Mary Anne Dilloway
Catherine N Caillouette
Margaret McCabe, Children's Hospital of Philadelphia, Philadelphia, PAFollow
David Wypij

Author ORCiD Identifier

Curley: 0000-0001-5228-6694

McCabe: 0000-0003-1322-0662

Publication Title

The Journal of pediatrics

Document Type

Article

PubMed ID

29246340

Abstract

OBJECTIVE: To describe the development and initial testing of the Braden QD Scale to predict both immobility-related and medical device-related pressure injury risk in pediatric patients.

STUDY DESIGN: This was a multicenter, prospective cohort study enrolling hospitalized patients, preterm to 21 years of age, on bedrest for at least 24 hours with a medical device in place. Receiver operating characteristic curves using scores from the first observation day were used to characterize Braden QD Scale performance, including areas under the curve (AUC) with 95% CIs.

RESULTS: Eight centers enrolled 625 patients. A total of 86 hospital-acquired pressure injures were observed in 49 (8%) patients: 22 immobility-related pressure injuries in 14 (2%) patients and 64 medical device-related pressure injuries in 42 (7%) patients. The Braden QD Scale performed well in predicting immobility-related and medical device-related pressure injuries in the overall sample, with an AUC of 0.78 (95% CI 0.73-0.84). At a cutoff score of 13, the AUC was 0.72 (95% CI 0.67-0.78), providing a sensitivity of 0.86 (95% CI 0.76-0.92), specificity of 0.59 (95% CI 0.55-0.63), positive predictive value of 0.15 (95% CI 0.11-0.19), negative predictive value of 0.98 (95% CI 0.97-0.99), and a positive likelihood ratio of 2.09 (95% CI 0.95-4.58).

CONCLUSIONS: The Braden QD Scale reliably predicts both immobility-related and device-related pressure injuries in the pediatric acute care environment and will be helpful in monitoring care and in guiding resource use in the prevention of hospital-acquired pressure injuries.

Keywords

Adolescent, Area Under Curve, Bed Rest, Child, Child, Preschool, Decision Support Techniques, Equipment and Supplies, Female, Hospitalization, Humans, Infant, Infant, Newborn, Male, Pressure Ulcer, Prospective Studies, ROC Curve, Risk Assessment, Risk Factors, Sensitivity and Specificity

DOI

10.1016/j.jpeds.2017.09.045

Publication Date

1-1-2018

Citation

Curley, M., Hasbani, N., Quigley, S., Stellar, J., Pasek, T., Shelley, S., Kulik, L., Chamblee, T., Dilloway, M., Caillouette, C., McCabe, M., & Wypij, D. (2018). Predicting Pressure Injury Risk in Pediatric Patients: The Braden QD Scale.. The Journal of pediatrics, 192, 189-195. https://doi.org/10.1016/j.jpeds.2017.09.045