Learn › Braden Scale
Braden Scale: how to score pressure injury risk
The Braden Scale predicts pressure injury risk by scoring six categories: sensory perception, moisture, activity, mobility, nutrition and friction and shear. Totals range from 6 to 23, and a lower score means higher risk; 18 or below usually means the client is at risk and needs a prevention plan.
The six Braden categories
| Category | What you assess | Points |
|---|---|---|
| Sensory perception | Can the client feel and report pressure or discomfort? | 1 to 4 |
| Moisture | How often the skin is wet from sweat, urine or stool | 1 to 4 |
| Activity | How much the client walks (bedfast, chairfast, walks occasionally, walks frequently) | 1 to 4 |
| Mobility | Can the client change and control body position? | 1 to 4 |
| Nutrition | Usual food intake | 1 to 4 |
| Friction and shear | Does the skin slide against sheets when the client moves or is moved? | 1 to 3 |
Risk levels
| Total score | Risk |
|---|---|
| 19 to 23 | Not at risk by score |
| 15 to 18 | Mild risk |
| 13 to 14 | Moderate risk |
| 10 to 12 | High risk |
| 9 or less | Very high risk |
Worked example
- A client after a stroke: responds only to pain on one side (sensory 2), often moist from incontinence (moisture 2), bedfast (activity 1), very limited mobility (mobility 2), eats about half of meals (nutrition 2), slides down in bed (friction and shear 1).
- Total: 2 + 2 + 1 + 2 + 2 + 1 = 10. High risk.
Interventions by what is low
- Mobility or activity low: reposition on a regular schedule (often every 2 hours, adjusted to the support surface and policy), use a pressure-redistribution surface, float the heels.
- Moisture low: clean and dry the skin promptly after incontinence and use a barrier cream.
- Nutrition low: involve the dietitian and encourage protein and fluids.
- Friction and shear low: use a lift sheet to move the client, and keep the head of the bed at 30 degrees or lower when possible.
NCLEX tip: The Braden score guides prevention but does not replace a skin assessment. Check bony areas (sacrum, heels, hips) every shift, whatever the score.
Practice this in NurseLingo
4,000+ NCLEX-style questions with rationales, 4,300+ flashcards on your lock screen and 380+ study podcasts, all in one app.
Get NurseLingo freeTest yourself: free fundamentals practice questions with answers and rationales.
Frequently asked questions
What Braden score is high risk?
10 to 12 is high risk and 9 or less is very high risk. Many facilities start a prevention plan at 18 or below.
Is a higher Braden score better?
Yes. Higher scores mean lower risk; 23 is the best possible score.
How often should the Braden Scale be done?
On admission and then on a schedule set by your facility, and again whenever the client's condition changes.
What is a score of 15 on the Braden Scale?
A Braden score of 15 means mild risk for a pressure injury (15 to 18 is mild risk). The client needs a prevention plan such as regular repositioning, pressure redistribution and moisture control.
What is a normal Braden score?
There is no "normal" score, but 19 to 23 is not at risk by score. Lower scores mean higher risk: 15 to 18 mild, 13 to 14 moderate, 10 to 12 high and 9 or less very high.
How to calculate a Braden score?
Score six categories: sensory perception, moisture, activity, mobility and nutrition (1 to 4 each) and friction and shear (1 to 3). Add them for a total from 6 to 23. Lower totals mean higher pressure injury risk.
Is a Braden score of 18 bad?
A score of 18 means mild risk; 18 or below generally means the client is at risk and needs a prevention plan, such as regular repositioning and pressure redistribution.
What is a perfect Braden score?
23, the highest possible total. It means no risk by score, but the skin still needs regular assessment.
Which scale is used for pressure ulcer risk assessment?
The Braden Scale is the most widely used in U.S. hospitals. It scores sensory perception, moisture, activity, mobility, nutrition and friction and shear.
Keep studying
Sources
- Preventing Pressure Ulcers in Hospitals, Tools and Resources (Braden Scale), Agency for Healthcare Research and Quality
- Pressure Injury, StatPearls, NCBI Bookshelf
For study only, not medical advice. Ranges and protocols vary by facility; follow your program, your facility's policies and the provider's orders.