ĐÁNH GIÁ KẾT QUẢ NHẬN ĐỊNH NGUY CƠ TỔN THƯƠNG DA DO ÁP LỰC THEO THANG ĐIỂM BRADEN CỦA ĐIỀU DƯỠNG TẠI BỆNH VIỆN ĐẠI HỌC Y DƯỢC THÀNH PHỐ HỒ CHÍ MINH

Abstract

Objective: To evaluate the assessment results of pressure injury risk using the Braden scale by clinical nurses compared with the gold standard, wound care specialist nurses, at University Medical Center Ho Chi Minh City. Methods: A descriptive cross-sectional study was conducted from February to June 2025 among 139 nurses from Internal Medicine, Surgery, and Intensive Care departments who had been trained in pressure injury risk assessment. Each nurse performed one Braden assessment, which was compared with an independent evaluation by a wound care specialist nurse (WOCN-certified). Diagnostic accuracy indices, including accuracy, sensitivity, specificity, positive/negative predictive values, and Cohen’s kappa, were analyzed. Results: The mean age of participants was 33.8 ± 6.4 years; 88.9% were female. The overall accuracy compared with the gold standard was 94.2% (95% CI: 89.1–97.1). Sensitivity was 95.9% (95% CI: 88.7–98.6), specificity 92.3% (95% CI: 83.2–96.7), PPV 93.4% (95% CI: 85.5–97.2), and NPV 95.2% (95% CI: 86.9–98.4). Cohen’s κ reached 0.884 (95% CI: 0.806–0.962), p < 0.001, indicating very high agreement. Mobility and friction/shear subscales showed the highest accuracy (≥ 96%), while nutrition had the highest error rate (12.2%). Conclusion: Clinical nurses at University Medical Center Ho Chi Minh City demonstrated high accuracy in assessing pressure injury risk using the Braden scale compared with wound care specialist nurses. The findings suggest the need for strengthened training and supervision on subscales prone to error, especially nutrition, and continued standardization of assessment protocols to enhance prevention of pressure injuries.