The entire nursing profession and the global caring community of WOC nurses mourn the death of Barbara Braden, while simultaneously celebrating her historic and significant contributions to nursing care on a global level, and WOC specialty practice nursing in particular. Barbara was born November 7, 1943 in North Platte Nebraska. She initially attended college at St. Catherine University in St. Paul, Minnesota and ultimately elected to pursue a career in nursing. She then obtained a diploma in nursing from St. Joseph's School of Nursing in Omaha Nebraska, a BSN from Creighton University in 1973, an MSN from the University of California San Francisco in 1975, and a PhD from the University of Texas at Austin in 1988. Following completion of her doctorate, Dr. Braden taught at the School of Nursing at Creighton University before promotion to Dean of the Graduate School and, ultimately, Dean of the College of Professional Studies until she retired from full-time academic administrative duties in 2011. In addition to her stellar accomplishments in her professional life, Barbara enjoyed a rich and loving personal and family life. In 2019, she married the love of her life and soulmate, Erin Wetzel. Barbara and Erin shared a love of animals (particularly shelter animals), social justice, travel, wine, and tennis.
Despite her rapid rise through the ranks of Academic Nursing, Dr. Braden retained her laser sharp focus on her overarching goal for entering nursing practice in the first place; improving the lives of patients by creating new knowledge and tools to support our practice. In what has proven to be an historically pivotal and amazingly productive partnership, Barbara collaborated with her colleague and friend, Dr. Nancy Bergstrom, to design and validate the Braden Scale for Pressure Sore Risk. Though many instruments for the measurement of pressure injury risk exist, the Braden Scale rose to the highest levels widespread use across the globe. The elements of the Braden Scale that have made it such an essential and foundational element of nursing care include its parsimony, its reliance on assessments within the reach of nurses with various levels of expertise in skin & wound care, its utility in suggesting effective preventive interventions, and its applicability to patients in multiple care settings.
While all nurses who have worked in the acute, post-acute, long-term, or home care setting are familiar with the Braden Scale, Barbara recognized, cultivated and celebrated a special relationship with the WOC nursing community. Long before the concept of "never-events" in acute care facilities was created and financial penalties for the occurrence of full thickness pressure injuries applied, WOC and Wound Care nurses had long advocated for unit-wide and facility-wide programs focusing on prevention of these largely avoidable events. Pioneering WOC nurses realized the need to accurately identify patients at risk (and particularly those at highest risk) for pressure injuries. WOC and Wound Care nurses were also trailblazers in understanding that "individualized assessment" did not adequately address this need or provide a framework for guiding preventive interventions. This gap in practice led WOC nurses to seek an effective instrument to assess thee risk for skin damage due to pressure and shearing forces, to determine the essential components of this risk, and to identify effective interventions for preventing injuries or mitigating pre-existing skin damage that led us to widespread adoption of the Braden Scale. WOC nurses acted as early champions of the Braden Scale by teaching nurses how to assess and score the various subscales, calculate a cumulative score, and use insights from these scores to guide preventive interventions. This focus on the role of the Braden Scale in pressure injury prevention, in turn, led to additional innovation in evaluating the various subscale as a guide to individualized intervention bundles based on each patient's needs. This focus on subscale scores also resulted in additional research elucidating relationships between risk factors identified in the Braden Scale and pressure injury development such as excessive moisture and full thickness pressure injuries.
These practice innovations and ongoing scholarly work did not go unnoticed by Dr. Braden. She consistently used opportunities to address clinical audiences on a global basis to publicly honor and praise WOC and Wound Care nurses for beathing life into the Braden Scale, for expanding its clinical utility by linking cumulative and subscale score to innovative and effective pressure injury prevention methods, and by testing its predictive validity in diverse care settings. She also publicly called out WOC nurses for expanding the concept of pressure injury care from a quality indicator of nursing care to the far more accurate conceptualization of pressure injury prevention as an indicator of overall care quality that was no less important in the emergency department, surgical suite, or diagnostic imaging area as compared to the inpatient acute or critical care unit.
Inevitably, research into the clinical breadth of the Braden Scaled revealed limitations when applied to certain areas such as the surgical suite or critical care unit. In a private conversation following a meeting in Canada, Barbara was asked about the emerging research identifying limitations of the Braden Scale. Her response was characteristic of the wisdom and grace she displayed throughout her life. She enthusiastically stated how proud she was of the nurses who completed that research, and gently reminded us of the original intent of the Braden Scale. When asked if she felt a personal responsibility to revise the Braden Scale, she replied "No, I will leave that responsibility to your generation." Not surprisingly, others have taken up Barbara's gentle but substantial challenge, resulting in the BradenQ and BradenQD scale and a plethora of studies seeking to adapt the Braden Scale to a variety of care settings. None of this disturbed Barbara in the least, nor does it dimmish the substantial magnitude of her contributions to the nursing profession, WOC and Wound Care specialty practice nursing, or pressure injury prevention as an interdisciplinary care initiative.
Barbara Braden can only be described as an icon! Her lifelong efforts to maximize the Braden Scale as foundational to pressure injury risk assessment and prevention are indisputable, as is the special relationship and mutual respect she shared with the global caring community of WOC Nurses. The DNA of her foundational, innovative, and historic contributions to pressure injury risk assessment is now indelibly etched into clinical practice guidelines and pressure injury prevention programs across the globe. Her contributions are similarly baked into the DNA of the WOCN Society, as reflected in her lifetime appointment as Editorial Advisor to the Journal of Wound, Ostomy and Continence Nursing, the Barbara Braden Future is Bright Award, and Barbara Braden Wound Care Lectureship.