This level of sensitivity and specificity are excellent and similar to that of mammography and physical examination in detecting breast cancer. In all settings the admission risk assessment is useful for planning immediate care, but in the SNF and VAMC on-going assessment provides for better prediction. When clinical assessment does not include formal risk assessment the use of turning and support surfaces, the two most common preventive measures, are not consistently implemented. When these interventions are used, they are most frequently used for women, persons over 75 years of age, and for Caucasians. Risk-based care planning uses either total scores, subscale scores or a combination to select preventive interventions.
Many informal presentations lend testimony to the efficacy of risk-based care planning.
The incidence of pressure ulcers, reported in 3 studies which will be reviewed, decreased with risk-based care planning and cost savings were reported. The Braden System is a computer assisted decision support system that guides the clinician through risk assessment, suggests risk-based care tailored to the specific patient risk factors, and monitors the outcomes for the individuals and the health care system.