No new significant updates or guidelines matching this topic were found today. We will check again soon.
Norton Scale
Norton Scale: The original pressure ulcer risk tool. Like Braden, a lower score indicates higher risk (maximum intact physiology = 20, lowest state = 5).
Rate 5 categories
1. Physical Condition
2. Mental State
3. Activity
4. Mobility
5. Incontinence
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Baseline risk assessment for pressure ulcers upon admission to hospital or long-term care.
Routine reassessment in older adults experiencing acute illness or functional decline.
Guiding the allocation of pressure-relieving mattresses and turning schedules.
The First Validated Tool
The Norton Scale, created in 1962, was the very first established risk assessment tool for pressure injuries. While the Braden Scale is more commonly used in the US today, the Norton Scale remains popular globally due to its simplicity and focus on the geriatric patient.
Section 2
Formula & Logic
Scoring
5 subscales, each scored 1 (worst) to 4 (best).
Total score: 5–20
Score ≤ 14 indicates "At Risk" for pressure ulcer development.
Score ≤ 12 indicates "High Risk".
Bedfast (1), Chairbound (2), Walk w/ help (3), Ambulant (4)
Mobility
Immobile (1), Very limited (2), Slightly limited (3), Full (4)
Incontinence
Doubly incontinent (1), Usually urinary (2), Occasional (3), Not (4)
Section 3
Pearls/Pitfalls
Lower is Worse
Like the Braden Scale, the Norton Scale operates on a "lower score equals higher risk" paradigm. A score of 20 means the patient has perfectly intact physiology and mobility. A score of 5 means profound multi-system failure and immobility.
Section 4
Next Steps
Management
Section 5
Evidence Appraisal
Primary Reference
An investigation of geriatric nursing problems in hospital.
Norton D et al. • London, National Corporation for the Care of Old People (now Centre for Policy on Ageing).. 1962;The original seminal text that defined modern pressure ulcer prevention.
Section 6
Origins
Doreen Norton
Developed by British nurse Doreen Norton and physician A.N. Exton-Smith. Their groundbreaking 1962 research challenged the prevailing belief that pressure ulcers were an inevitable consequence of aging, proving instead they were a failure of nursing care related to immobility.
