Braden Scale Calculator
Braden pressure injury risk score from six clinical subscales.
What it does
The Braden Scale estimates a patient's risk of developing a pressure injury. It was designed for adults in hospital and long-term care and is widely used to trigger skin care, repositioning, and support surface planning.
The tool above scores six areas: sensory perception, moisture, activity, mobility, nutrition, and friction and shear. Five areas use a 1 to 4 scale, while friction and shear uses 1 to 3. The total runs from 6 to 23.
Lower scores point to higher risk. A total of 18 or less is commonly used as the threshold for risk, with bands that separate mild, moderate, high, and very high risk. The subscales matter because two patients can share a total while needing different interventions.
Use the score as one part of a skin assessment, not as a diagnosis. The scale does not replace inspection, mobility care, nutrition review, or facility policy, and it is not validated for every patient population.
How to use
- Score sensory perception from 1 (completely limited) to 4 (no impairment).
- Score moisture from 1 (constantly moist) to 4 (rarely moist).
- Score activity and mobility from 1 (bedfast or completely immobile) to 4 (walks frequently or no limitation).
- Score nutrition from 1 (very poor) to 4 (excellent).
- Score friction and shear from 1 (problem) to 3 (no apparent problem).
- Read the total and risk band, then review the lowest subscales for care planning.
Formula
- sensory perception
- Ability to feel and respond to pressure-related discomfort, scored 1 to 4.
- moisture
- Degree to which skin is exposed to moisture, scored 1 to 4.
- activity and mobility
- Physical activity level and ability to change position, each scored 1 to 4.
- nutrition
- Usual food intake pattern, scored 1 to 4.
- friction and shear
- Risk from sliding or pulling across surfaces, scored 1 to 3.
The maximum is 23: five subscales at 4 plus friction and shear at 3. The minimum is 6: five subscales at 1 plus friction and shear at 1. A total of 18 or less is generally considered at risk.
Worked example
Example: total score of 16
Sensory 4, moisture 3, activity 3, mobility 2, nutrition 2, friction and shear 2.
- Sensory perception: 4 points.
- Moisture: 3 points, for a running total of 7.
- Activity: 3 points, running total 10.
- Mobility: 2 points, running total 12.
- Nutrition: 2 points, running total 14.
- Friction and shear: 2 points, final total 16.
- A total of 16 falls in the mild risk band, but the mobility and nutrition scores still warrant review.
Reference table
| Total score | Risk band | At risk? |
|---|---|---|
| 9 or less | Very high risk | Yes |
| 10 to 12 | High risk | Yes |
| 13 to 14 | Moderate risk | Yes |
| 15 to 18 | Mild risk | Yes |
| 19 to 23 | No risk indicated | No |
Limits
- Developed for adult hospital and long-term care patients. Pediatric, neonatal, and some specialty populations need a validated alternative.
- A total score can hide a severe deficit in one subscale. Review the individual scores, not just the sum.
- Does not replace direct skin inspection or account for existing pressure injuries, medical devices, or immobility during procedures.
- Risk band cutoffs vary by facility policy and version of the scale. Follow the protocol where the patient is being cared for.
Common mistakes
- Scoring friction and shear on a 1 to 4 scale instead of 1 to 3.
- Scoring the patient from memory instead of observing current mobility and moisture.
- Using the total alone and ignoring a very low nutrition or mobility score.
- Treating a score above 18 as proof that no prevention is needed.
- Applying adult Braden thresholds to a pediatric patient without a validated tool.
Try it yourself
Quick checks. Answers sit tucked under each question.
A patient scores 2, 2, 1, 1, 2, and 1 across the six subscales. What is the total and risk band?
The total is 2 + 2 + 1 + 1 + 2 + 1 = 9, which is very high risk.
A patient scores 4 on all five 1 to 4 subscales and 3 on friction and shear. What is the total?
Five 4s make 20, plus 3 gives 23. That is the maximum score and falls in the no risk indicated band.
A patient scores 3, 3, 3, 3, 3, and 3. What is the total and risk band?
The total is 18, which is mild risk. A score of 18 is still at or below the common at-risk threshold.
Questions
What is a normal Braden score?
There is no single normal score. Higher scores mean lower risk, and 19 to 23 is often labeled no risk indicated. Any score needs clinical context.
Is 18 a high Braden score?
No. Eighteen is the usual at-risk cutoff, so 18 or less is generally considered at risk. Higher scores, up to 23, indicate lower risk.
How often should the Braden Scale be scored?
Follow facility policy and patient condition. Many hospitals score on admission and at set intervals, with more frequent checks when risk or condition changes.
Does a low Braden score mean the patient will get a pressure injury?
No. It identifies elevated risk. Prevention, skin care, nutrition, and mobility support can change the outcome.
Can the Braden Scale be used in children?
The original scale is for adults. Pediatric risk assessment usually uses a validated pediatric tool such as the Braden Q.
Why is friction and shear scored out of 3?
That subscale has three descriptive levels rather than four, so its maximum is 3. The other five subscales each max out at 4.
Sources
- AHRQ: Braden Scale for predicting pressure sore risk
- NHS: Braden Scale guidelines
- PMC: Braden Scale risk categories