Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Individual Braden Subscale Intervention Checklist

Magnan, M & Maklebust, J. Braden Scale Risk Assessments and Pressure Ulcer Prevention Planning: What’s the Connection? Journal of Wound, Ostomy and Continence Nursing, Volume 36, Issue 6, page 622-634.
 
Reprinted with permission from Wolters Kluwer Health
From the list provided, make a check mark next to the prevention intervention that you think should be implemented for this patient based on YOUR assessment.
 
 
Check if should be implemented
1.     Implement a whole body repositioning schedule in the room or chart.
 
 
_________
2.     Use a 30 degree lateral side-lying angle to avoid positioning onto sacral and trochanteric bony prominences.
 
 
 
_________
3.     Use pillow or foam positioning wedges to maintain in desired position.
 
 
_________
4.     Use a pressure reducing support surface while in bed.
 
 
_________
 
5.     Float/suspend heels off bed.
 
_________
6.     Use a pressure reducing chair cushion while sitting.
 
 
_________
7.     Pad between bony prominences (e.g. knees and ankles.
 
 
_________
8.     Consult a dietician for nutritional concerns.
 
_________
9.     Protect skin from moisture.
 
_________
10.   Protect skin from friction and shear.
_________