Anyone who provides care for frail elderly patients understands the inherent risk of skin integrity issues. Sadly, as we age, our skin also ages, losing elasticity, muscle, adipose tissue, etc. which can increase the risk of developing pressure injuries. Pretty much since the beginning of time, the Braden scale has been used to assess a resident’s risk of developing a wound but recently, this tool has come under scrutiny.

Several studies have supported that the Braden scale has low discrimination for predicting the outcome and prognosis of pressure injuries in older patients. As a clinician, I can honestly say I’m not surprised. As HealthCap risk managers travel the country providing education on best practices for assessing resident risk, most members identify the Braden as the universal “gold standard”.

We share with our members that no tool, no matter how well researched, how well respected, or how long it has been the “gold standard” can replace the nurse. Yes, nurses have the ability to assess risk better than any tool because tools don’t have eyes on the resident and aren’t able to have a conversation with the resident regarding lifestyle and habits.  It isn’t magic, and there is no crystal ball, however; remember, no tool can replace a strong, clinician. Stay well, stay informed, and stay tuned!