Cent Eur J Nurs Midw 2013, 4(3):609-613

Using the Braden scale for the prediction of pressure sore risk: inter-rater reliability

Petra Mandysová^1,2,*, Jana Pechová^1,2, Edvard Ehler^2,1

¹ Department of Nursing, Faculty of Health Studies, University of Pardubice

² Neurology Clinic, Pardubice Regional Hospital

Aim: The accuracy of the screening scales for identification of patients who are at risk of developing pressure sores has, so far, received only marginal attention in the Czech Republic. The aim was to extend a pilot study that focused on inter-rater reliability of the Braden Scale and to determine inter-rater reliability for a larger patient sample.

Methods: Two raters performed independent assessments of 60 patients hospitalized with a neurological disease, using the Braden Scale. Total scores (max. 23 points) were dichotomized (at risk versus not at risk) using the recommended cut-off score (18 points). Using the kappa (κ) coefficient, inter-rater reliability was expressed for the dichotomized total scores as well as for scores obtained for each category of the scale.

Results: For the dichotomized total results, the κ coefficient was 0.564 (95% confidence interval [CI] = 0.182; 0.946). For the individual categories, the κ coefficient was as follows: "sensory perception" 0.557 (95% CI = 0.306; 0.808); "moisture" 0.454 (95% CI = 0.142; 0.766); "activity" 0.613 (95% CI = 0.425; 0.801); "mobility" 0.091 (95% CI = - 0.127; 0.309); "nutrition" 0.283 (95% CI = 0.095; 0.471); and "friction and shear" 0.554 (95% CI = 0.240; 0.868).

Conclusion: For the dichotomized total scores, moderate inter-rater reliability (κ = 0.564) was obtained. For the category "activity", the inter-rater reliability was quite good (κ = 0.613); for other categories, it was lower. Factors that may have affected the results are discussed.

Keywords: cut-off score, pressure sore, inter-rater reliability, screening, Braden Scale

Published: September 30, 2013  Show citation