| Summary: | This study is designed to evaluate the effectiveness of using PU RASs(the Braden scale) on patients' outcomes in terms of PU incidence. The study aimed to examine the effects of RASs (the Braden scale) compared to the effects of PU training and nurses' clinical judgement on patients' outcomes in terms 6fPU incidence. A non-equivalent pretest posttest controlled groups designs were used and the data were gathered using an observational checklist, the Braden scale for PU risk assessment, and nurses' clinical judgement rating scale. 719 hospitalised patients at Riyadh Military Hospital in Saudi Arabia were selected from 9 Medical-Surgical wards and were divided into 3 groups (A, B and C). In Group A, nurses received training on the Braden scale; in Group B, nurses received PU training, ,and Group C was control. The Braden score of:s 18 was used as a cut off score to determine at risk patients. The Agency for Health Care Policy and Research (AHCPR) (1992) classification system was used to consider PU incidence. Data were collected by one tissue viability specialist and two researchers. The findings showed that 22.9% of the patients developed PU (stage one to stage four). The PU incidence was relatively similar between the study groups (24.4% in Group A, 23.4% in Group B, a,nd 21.1% in Group C) which demonstrates no significant effect for using RASs (the Braden scale) compared to PU training and nurses' clinical judgment on PU incidence. The findings also pointed out a significant difference in PU incidence among pretest (31%) patients and posttest (19%) patients which suggest the clinical benefit of the PU prevention programme implemented by the RMH. Logistic regression analysis revealed that age, clinical judgement scores, Braden scores, standard hospitalbed mattress, neuro-surgical diagnosis, and skin barrier creams have predictive function in relation to PU development. The ROC analysis showed a relatively similar performance for Braden scale and nurses' clinical judgement in relation to PU development. The study concluded no significant effect of using RASs (the Braden scale) on patients' outcomes in terms of PU incidence reduction. In respect to this, the study suggests that .RASs (the Braden scale) and nurses' clinical judgement can be used together to improve patients' outcomes in terms ofPU development.
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