Braden Scale for Predicting Pressure Ulcer Risk

The Braden Scale for Predicting Pressure Sore Risk is a chart developed by Barbara Braden and Nancy Bergstrom in the 1980s. Medical professionals use this chart to assess patients' risk of developing bedsores, also called pressure sores or pressure ulcers. Many hospitals have adopted this scale and use it to provide preventative care to patients at risk of developing pressure sores/ulcers. The chart has six categories: sensory perception, moisture, activity, mobility, nutrition, and friction or shear, to measure patients' risk accurately.

Pressure sores/ulcers are areas of damaged tissue that develop when prolonged pressure reduces blood flow to the skin. While usually treatable, some of the damage from pressure sores/ulcers may be permanent. Additionally, some pressure sores/ulcers are prone to life-threatening infections.

Overview

Nurse Barbara Braden first developed the Braden Scale for Predicting Pressure Sore Risk in the 1980s. Together with Dr. Nancy Bergstrom and colleagues, Braden tested this scale for several years and released the results in the late 1980s. The scale was designed as a method for hospital workers to assess patients' risk of developing pressure sores/ulcers, allowing them to treat their patients in a more informed manner.

The scale quickly grew in popularity. Professionals translated the scale into several languages, and healthcare workers in hospitals around the world began to use it. Medical institutions could match their preventive care measures to whatever risk level the patient was measured at by the chart.

The Braden Scale splits a patient's risk for developing pressure sores into six categories: sensory perception, moisture, activity, mobility, nutrition, and friction or shear. Each category receives a score based on the patient’s condition. Most categories are scored from one to four, while friction and shear are scored from one to three. The total score ranges from six to twenty-three, and lower scores indicate a higher risk of developing pressure sores/ulcers.

Sensory perception refers to a patient's ability to respond to painful sensations related to pressure. It includes a patient's ability to feel pain and their ability to communicate such pain to others, both of which can be impaired by sedation. Moisture refers to the dryness of the patient's skin. Activity refers to the patient's level of physical activity. Certain injuries can impair a patient's ability to move, so some patients may have low activity levels. Nutrition refers to the patient's diet. Finally, friction and shear describe forces that occur when a patient’s skin rubs or slides against surfaces such as bedding. Some patients may be able to sit up, shift, and move themselves without difficulty. Others may be unable to move without assistance.

These injuries are most common in bedridden individuals or individuals who use wheelchairs. Because these individuals often cannot move themselves, they require periodic assistance to prevent the formation of pressure sores/ulcers.

Most individuals who develop pressure sores/ulcers recover with proper treatment. However, some tissue damage caused by the sores may never fully heal. Additionally, pressure sores/ulcers can result in difficult-to-treat infections, which can be life-threatening. Symptoms of pressure sores/ulcers include unusually tender skin, swelling, pus draining, and oddly colored skin. Pressure sores/ulcers occur most commonly in bony areas of the body, such as the heels, ankles, hips, back, and shoulder blades.

Bibliography

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"Bedsores (Pressure Ulcers)." Mayo Clinic, 22 Feb. 2024, www.mayoclinic.org/diseases-conditions/bed-sores/symptoms-causes/syc-20355893. Accessed 14 Mar. 2026.

Bergstrom, N., et al. "The Braden Scale for Predicting Pressure Sore Risk." Nursing Research, vol. 36, no. 4, July–Aug. 1987, pp. 205–10.

Braden, Barbara. "25th Anniversary Commentary: The Braden Scale for Predicting Pressure Sore Risk: Reflections After 25 Years." Advances in Skin & Wound Care: The Journal for Prevention and Healing, vol. 25, no. 2, Feb. 2012, p. 61.

Braden, Barbara, and Nancy Bergstrom. "Braden Scale–For Predicting Pressure Sore Risk." Indiana State Department of Health, www.in.gov/isdh/files/Braden_Scale.pdf. Accessed 14 Mar. 2026.

Brazier, Yvette. "Bedsores or Pressure Ulcers: What You Need to Know." Medical News Today, 8 Nov. 2023, www.medicalnewstoday.com/articles/173972. Accessed 14 Mar. 2026.

Kirkman, Christian N. "Pressure Injuries (Pressure Ulcers) and Wound Care Treatment & Management." Medscape, 31 Jan. 2024, emedicine.medscape.com/article/190115-treatment. Accessed 14 Mar. 2026.

"Pressure Sores." MedlinePlus, 18 Dec. 2024, medlineplus.gov/pressuresores.html. Accessed 14 Mar. 2026.

Triplett, Tara Call. “The Braden Scale Score for Predicting Pressure Injury Risk.” Wound Care Education Institute, 5 Mar. 2024, blog.wcei.net/braden-scale-score-for-predicting-pressure-injury-risk. Accessed 14 Mar. 2026.