<P> Friction and shear looks at the amount of assistance a client needs to move and the degree of sliding on beds or chairs that they experience . This category is assessed because the sliding motion can cause shear which means the skin and bone are moving in opposite directions causing breakdown of cell membranes and capillaries . Moisture enhances the susceptibility of friction . </P> <P> Each category is rated on a scale of 1 to 4, excluding the' friction and shear' category which is rated on a 1 - 3 scale . This combines for a possible total of 23 points, with a higher score meaning a lower risk of developing a pressure ulcer and vice versa . A score of 23 means there is no risk for developing a pressure ulcer while the lowest possible score of 6 points represents the severest risk for developing a pressure ulcer . The Braden Scale assessment score scale: </P> <Ul> <Li> Very High Risk: Total Score 9 or less </Li> <Li> High Risk: Total Score 10 - 12 </Li> <Li> Moderate Risk: Total Score 13 - 14 </Li> <Li> Mild Risk: Total Score 15 - 18 </Li> <Li> No Risk: Total Score 19 - 23 </Li> </Ul> <Li> Very High Risk: Total Score 9 or less </Li>

What does a braden score of 20 mean