Date of Conferral

2021

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Patti Senk

Abstract

Healthcare acquired pressure injuries (HAPIs) are a serious and debilitating condition in the elderly, and it is therefore critical to reduce the incidence of HAPIs. Mitigation strategies are often implemented for patients who score in the highest risk categories on the Braden Scale for Predicting Pressure Sore Risk©. Yet, the evidence suggests vulnerable older adults who score in the midrange of the Braden Scale, and specifically, the mobility subscale, develop HAPI more frequently. The review question centered on the evaluation of the current evidence for early mitigation strategies in response to Braden Scale midrange mobility subscale scores. The gap addressed was the frequent oversight of mitigation strategies for vulnerable older adults that score in the midrange of the Braden Scale mobility subscale. The Stevens Star Model of Knowledge guided the development of this systematic review. A Preferred Reporting Items for Systematic Reviews and Meta-Analysis flow diagram was used to identify eligible articles. Melnyk and Fineout-Overholt’s levels of evidence and critical appraisal of the evidence guided assessment of evidence. There were 21 full text articles assessed for eligibility; 2 studies reviewed the Braden Scale mobility subscale's predictive capability. The results of this systematic review failed to show adequate evidence to suggest the mobility subscale as a reliable, independent pressure injury risk assessment tool. Nonetheless, the mobility subscale score presents opportunity to further evaluate implementation of mitigation strategies to decrease HAPI, decrease cost to the healthcare system, and promote social change with improvement in skin integrity in elderly patients.

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