BRADEN SCALE RESULT

Date and time: [Date, time]
Patient: [Name or ID, age]
Setting: [Hospital unit, long-term care, or home visit]
Reason: [Admission, shift or scheduled reassessment, change in condition, transfer, or discharge]
Version: [Braden Scale or Braden Scale II, from the facility's licensed form]
Scored by: [Name, credentials]

SCORES
Sensory perception: [1 to 4]
Moisture: [1 to 4]
Activity: [1 to 4]
Mobility: [1 to 4]
Nutrition: [1 to 4]
Friction and shear: [1 to 3]
Total: [6 to 23]
Risk level: [Very high, high, moderate, mild, or no added risk]
Other risk factors: [Advanced age, fever, poor protein intake, low blood pressure, unstable condition, medical devices, or none]

TREND
Previous scores: [Dates and totals]
Change: [Better, worse, or the same, and why]

SKIN INSPECTION
Areas checked: [Sacrum, coccyx, heels, hips, elbows, back of the head, ears, and skin under devices]
Findings: [Intact, or redness that blanches or doesn't, with site and size]
Pressure injury: [Stage, site, and size for each, or none]
Devices: [Tubes, masks, splints, casts, or stockings, and the skin under them]

PREVENTION PLAN
Repositioning: [Turning schedule, positions, and who helps]
Support surface: [Mattress or seat cushion type, or standard]
Heels: [Floated with pillows or boots, or not needed]
Moisture: [Continence care, barrier cream, and pads]
Nutrition: [Intake, weight, dietitian referral, and supplements]
Friction and shear: [Head of bed angle, lift sheet, and transfer aids]
Teaching: [What the patient or family was taught, and what they understood]

NEXT ASSESSMENT
Reassess: [Next shift, date, or the interval the setting requires]
Reported to: [Charge nurse, provider, wound care nurse, or dietitian, and when]

Signed: [Name, credentials, date and time]