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Background Pressure ulcers remain a serious problem for patients and providers in healthcare. When a pressure ulcer develops, it can inflict pain and cause untoward complications such as severe infections, surgery, prolonged hospital stay and even death. Objective The objective of this review was to establish whether using the Braden subscale mobility assessment is comparable to using the full Braden pressure ulcer risk assessment scale. However, due to lack of research studies, the focus of this review was extended to include the use of other assessment tools for hospital acquired pressure ulcer risk. Inclusion Criteria Types of Studies Quantitative studies that reported data on mobility and pressure ulcer development or preventive interventions, irrespective of their design were included in the review. Types of Participants The review focused on adult patients admitted to an acute care facility, who underwent a pressure ulcer risk assessment, and had no pressure ulcers on admission. Types of Interventions This review considered studies that use Braden mobility subscale assessment Types of Comparator This review compared the use of full Braden risk assessment scale where available only when it was included within the same study, Types of Outcome Measures This review considered: • Incidence of hospital acquired pressure ulcers • Endorsement or initiation of preventive interventions • Reliability of Braden mobility subscale assessment to identify patients at risk of developing pressure ulcer with or without Braden assessment. For the purposes of this systematic review, reliability of the mobility scale means predictive validity. • Frequency of using Braden mobility subscale assessment Search Strategy A search for published and unpublished studies from 2000 to 2010 of major healthcare related electronic databases was conducted. Studies in other languages that were translated into English were included in the review. Assessment of Quality The papers that were selected for possible inclusion were assessed by two independent reviewers for methodological validity using standardised critical appraisal instruments from the Joanna Briggs Institute. Data Collection and Analysis Data from included studies were extracted and analysed using Revman5 software. Results and Conclusions Eighteen studies were included in this review. The findings suggest that the risk of pressure ulcer development was higher when the patient was identified as having impaired mobility, as assessed using the Braden subscale mobility or other similar mobility scales. However, there is little conclusive evidence to indicate that using mobility assessment alone is comparable to using Braden or other risk assessment scales in reducing the incidence of pressure ulcer. Evidence for association between assessment of mobility and endorsement of preventive interventions was significant. However, this finding was based on only one study. No evidence found on the reliability of mobility assessment as a tool to predict pressure ulcer risk. Nor was there evidence on the frequency of assessment using the mobility assessment tool. |
