Prevention Plus provides services and products related to the Braden Scale for Predicting Pressure Sore Risk© and evidence-based programs of pressure ulcer prevention. Prevention Plus was founded in 1998 by Barbara Braden and Nancy Bergstrom and is based on their extensive research in patient care. Many of the Prevention Plus products based on this research are provided without charge. These products are all you need to implement an evidence-based program of prevention.

Some of the products consist of educational materials that were time consuming and expensive to develop. There is a

nominal purchase price or rental for these products. While these materials are not absolutely essential to implementation and ongoing outcomes management in a program of pressure ulcer prevention, the use of these products may help simplify the process.

Our Mission
The mission of Prevention Plus is to provide health care professionals with a simple way to obtain information related to the Braden Scale for Predicting Pressure Sore Risk and its appropriate use in a program of prevention of pressure ulcers. We are committed to providing accurate, evidence-based information and practical tools to the many health professionals who are striving to improve the quality of care in their facilities or agencies.

History of the Braden Scale
The Braden Scale for Predicting Pressure Sore Risk was developed during a Robert Wood Johnson Teaching Nursing Home project and while writing an NIH proposal to study pressure ulcer risk factors. The Braden Scale was initially tested for reliability and validity and these results were published in Nursing Research in 1987. A larger multi-site study was conducted to determine the reliability and validity of the tool in a variety of settings resulting in revisions in the recommendations for the critical cutoff score and the timing of assessment. Results were published in Nursing Research in 1998. A follow-up report in Nursing Research in 2002 demonstrated that the tool could be used in Black and White subjects with similar validity. This tool is in use on all continents and has been translated into many languages, including Japanese, Chinese, Korean, Indonesian, Italian, German, Portuguese, Polish, Arabic, Finnish, Norwegian, Icelandic, Flemish, Croatian, Dutch and French. Two tools have undergone formal translation validation and are included on this Web site.

The Braden Scale has been disseminated widely, translated into many languages, and is used to some extent around the world-wide. A recent systematic review by Pancorbo-Hildalgo and colleagues (2006) examined studies of various risk assessment tools published in Spanish, English, French and Portuguese and performed a meta-analysis to determine which of the many risk assessment tools available demonstrated the best reliability and validity. They compared the Braden Scale, Norton Scale, and the Waterlow Scale. They concluded that the Braden Scale had been tested in the largest number of studies, had demonstrated the best reliability and validity indicators in a variety of settings, and was a better predictor of pressure ulcers than nursing judgment.

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