Modified Braden Q Scale (Pediatric Risk Assessment Tool)

Julian L. Gallegos, MS, RN, FNP-BC

EBP Tool to Assess Pediatric Skin

 For sometime now, NorthBay has used the Braden

scale to assess our adult patients risk for skin breakdown and need for implementation of prevention measures.  Current EBP suggests we utilize tools specific for age in assessing risk for skin breakdown.


Pressure ulcers in pediatrics patients have been reported to occur by a patient's second hospital day (Curley, Quigley, & Lin, 2003).

 With CERNER implementation of the IPOC we will be

introducing the use of the Modified Braden Q Scale for our pediatric patients.

Modified Braden Q Scale

 The Modified Braden Q Scale is similar to the

Adult Braden Scale with some minor modifications.

 

The tool was developed by two nurses, Dr. Martha Curley and Dr. Sandy Quigley. Evidence indicates the tool is reliable in predicting skin breakdown in children ages 29days less than 5 years of age.


For children 5 years and older the Adult Braden Scale is acceptable in assessing the childs risk for skin breakdown.

Modified Braden Q Scale



The tool allows the nurse to assess the patients:

1. 2. 3. 4. 5. 6. 7.

Mobility Activity Sensory Perception Moisture Friction-Shear-Friction Nutrition Tissue Perfusion & Oxygenation

Modified Braden Q Scale

 The Braden Q Scale modifications of the

adult-based tool reflect:



The unique developmental characteristics of pediatric patients The prevalence of gastric/transpyloric tube feedings The availability of blood studies and noninvasive technology in the acute care pediatric setting.

Modified Braden Q Scale Score

 The Braden Q Scale is composed of seven subscales.

All seven subscales are rated from 1 (least favorable) to 4 (most favorable); patients receive only one score per subscale.  Total Braden Q Scale scores range from 7 (highest risk) to 28 (lowest risk), with a score of 16 or lower identifying pediatric patients at risk for pressure ulcers (Curley et al., 2003).  In both the Braden and Braden Q Scales, a higher score generally indicates healthier patient condition and function.  The lower score will allow the RN to initiate skin saving precautions and implement the Pediatric Skin plan of care within CERNER.


Modified Braden Q within CERNER

Nursing Implications
 The use of a risk assessment scale to identify

patients at risk, in combination with a comprehensive skin assessment and clinical judgment, is key to the success of our comprehensive Save our Skin pressure ulcer prevention program.