Proposed Research Question
How effective is the Braden Scale in predicting the occurrence of Hospital-acquired pressure injuries (HAPrIs) among surgical critical care patients?
Independent and Dependent Variables
Independent Variable
Braden Scale assessment
Dependent or Outcome Variable
Occurrence of Hospital-acquired pressure injuries (HAPrIs)
Intervening and/or Confounding Variables
Patient demographics, comorbidities, length of ICU stay, and level of nursing care
Additional Terms to Define
Surgical critical care patients
Conceptual and Operational Definitions of the Variables
Conceptual Definitions
The Braden Scale assessment is a standardized technique for determining a patient’s risk of getting pressure ulcers based on perceptions of sensations, wetness, activity, mobility, nutrition, and friction/shear (Jansen et al., 2020).
HAPrIs are skin injuries that arise during a hospitalization (Alderden et al., 2021).
Surgical critical care patients include persons admitted to the surgical ICU or cardiovascular postoperative ICU for critical care.
Operational Definitions
The Braden Scale score is obtained from electronic health records or direct patient assessment.
HAPrIs refers to the presence of pressure injuries documented in the patient’s medical records throughout their ICU treatment.
Surgical critical care patients are those hospitalized in specialized ICUs after surgery and requiring critical care.
Theoretical Framework
The theoretical basis for this study is the broader context of predictive modeling and risk assessment in medical settings. The Health Belief Model (HBM) is the main theoretical perspective, which states that people are more likely to engage in health-promoting actions if they perceive themselves to be at risk of an adverse health outcome and believe that taking a specific action will reduce that risk. The application of this paradigm to pressure injury prevention implies that appropriate risk assessment tools, such as the Braden Scale, might influence healthcare personnel’s views of patient fragility and help inform preventive measures.
Inclusion and Exclusion Criteria for Participants
Patients hospitalized in the surgical ICU or cardiovascular surgical ICU after surgery will be included to focus on a group at high risk of pressure injuries due to the demands of postoperative critical care (Alderden et al., 2021).
Patients with existing pressure injuries, those transferred from other ICUs, and those with incomplete medical records will be excluded from the study to ensure a representative sample and a precise evaluation of the relationship between Braden Scale scores and HAPrIs.
Proposed Research Design and Rationale
A retrospective cohort design enables the study of the relationship between the Braden Scale assessment and the prevalence of HAPrIs among surgical critical care patients over time. This framework allows the use of electronic health record data, aligning with the methods used by Alderden et al. (2021), and provides vital insights into the reliability of predictions. A retrospective strategy also ensures the collection of comprehensive data, which reduces recall bias and improves the study’s internal validity. Jansen et al. (2020) endorse the use of the Braden Scale to predict pressure ulcer development, offering a theoretical foundation for the study’s methodology.
References
Alderden, J., Drake, K. P., Wilson, A., Dimas, J., Cummins, M., & Yap, T. L. (2021). Hospital acquired pressure injury prediction in surgical critical care patients. BMC Medical Informatics and Decision Making (Online), 21(1).
Jansen, R. C. S., De Almeida Silva, K. B., & Moura, M. E. S. (2020). Braden Scale in pressure ulcer risk assessment. Revista Brasileira De Enfermagem, 73(6).