Fillable Braden Details

In this post, the author discusses the Braden Scale Form. The scale is a questionnaire with a series of questions in order to identify any underlying medical conditions in patients who are experiencing symptoms such as fatigue and weight loss. These symptoms can be signs of an underlying disease or condition. The author also lists down some factors that should be considered before using the Braden Scale form for assessment purposes. The Braden Scale Form is a questionnaire used by doctors to assess whether your patient may have an underlying medical condition affecting their health. In this blog post, I will discuss how you can use the scale effectively during diagnosis and what factors need to be taken into account beforehand so that it doesn't lead to inaccurate results or delays in treatment when needed most.

This table features specifics of braden scale form. Our recommendation is that you look at this information before you decide to start filling out the file.

Form NameBraden Scale Form
Form Length2 pages
Fillable fields0
Avg. time to fill out30 sec
Other namesbraden risk, braden scale template, braden scale form, braden pressure

Form Preview Example


Patient=s Name _____________________________________

Evaluator=s Name________________________________

Date of Assessment








1. Completely Limited


2. Very Limited

3. Slightly Limited

4. No Impairment


Unresponsive (does not moan,


Responds only to painful

Responds to verbal com-

Responds to verbal

ability to respond meaning-

flinch, or grasp) to painful


stimuli. Cannot communicate

mands, but cannot always

commands. Has no

fully to pressure-related

stimuli, due to diminished level of


discomfort except by moaning

communicate discomfort or the

sensory deficit which would


con-sciousness or sedation.


or restlessness

need to be turned.

limit ability to feel or voice






pain or discomfort..


limited ability to feel


has a sensory impairment which

has some sensory impairment



pain over most of body


limits the ability to feel pain or

which limits ability to feel pain





discomfort over 2 of body.

or discomfort in 1 or 2 extremities.









1. Constantly Moist


2. Very Moist

3. Occasionally Moist:

4. Rarely Moist


Skin is kept moist almost


Skin is often, but not always moist.

Skin is occasionally moist, requiring

Skin is usually dry, linen

degree to which skin is

constantly by perspiration, urine,


Linen must be changed at least

an extra linen change approximately

only requires changing at

exposed to moisture

etc. Dampness is detected


once a shift.

once a day.

routine intervals.


every time patient is moved or


















1. Bedfast


2. Chairfast

3. Walks Occasionally

4. Walks Frequently


Confined to bed.


Ability to walk severely limited or

Walks occasionally during day, but

Walks outside room at least

degree of physical activity



non-existent. Cannot bear own

for very short distances, with or

twice a day and inside room




weight and/or must be assisted into

without assistance. Spends

at least once every two




chair or wheelchair.

majority of each shift in bed or chair

hours during waking hours








1. Completely Immobile


2. Very Limited

3. Slightly Limited

4. No Limitation


Does not make even slight


Makes occasional slight changes in

Makes frequent though slight

Makes major and frequent

ability to change and control

changes in body or extremity


body or extremity position but

changes in body or extremity

changes in position without

body position

position without assistance


unable to make frequent or

position independently.





significant changes independently.










1. Very Poor


2. Probably Inadequate

3. Adequate

4. Excellent


Never eats a complete meal.


Rarely eats a complete meal and

Eats over half of most meals. Eats

Eats most of every meal.

usual food intake pattern

Rarely eats more than a of any


generally eats only about 2 of any

a total of 4 servings of protein

Never refuses a meal.


food offered. Eats 2 servings or


food offered. Protein intake

(meat, dairy products per day.

Usually eats a total of 4 or


less of protein (meat or dairy


includes only 3 servings of meat or

Occasionally will refuse a meal, but

more servings of meat and


products) per day. Takes fluids


dairy products per day.

will usually take a supplement when

dairy products.


poorly. Does not take a liquid


Occasionally will take a dietary


Occasionally eats between


dietary supplement




meals. Does not require





is on a tube feeding or TPN



is NPO and/or maintained on


receives less than optimum amount

regimen which probably meets



clear liquids or IV=s for more


of liquid diet or tube feeding

most of nutritional needs



than 5 days.












1. Problem


2. Potential Problem

3. No Apparent Problem



Requires moderate to maximum


Moves feebly or requires minimum

Moves in bed and in chair



assistance in moving. Complete


assistance. During a move skin

independently and has sufficient



lifting without sliding against


probably slides to some extent

muscle strength to lift up



sheets is impossible. Frequently


against sheets, chair, restraints or

completely during move. Maintains



slides down in bed or chair,


other devices. Maintains relatively

good position in bed or chair.



requiring frequent repositioning


good position in chair or bed most




with maximum assistance.


of the time but occasionally slides




Spasticity, contractures or






agitation leads to almost






constant friction











8 Copyright Barbara Braden and Nancy Bergstrom, 1988 All rights reserved

Total Score

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