No new significant updates or guidelines matching this topic were found today. We will check again soon.
Waterlow Score
Waterlow Score: Unlike Braden, a HIGHER score means HIGHER risk. Please select the most severe applicable factor in each category.
Base Assessment
Build / Weight for Height
Visual Skin Type (Worst area)
Sex
Age
Continence
Mobility
Special Risks (Select all that apply)
Tissue Malnutrition (Score +8)
Neurological Deficit (Score +4 to +6)
Major Surgery / Trauma (Score +5)
Medication Risks (Score +4)
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Standardised pressure ulcer risk screening on admission to hospital or care home.
The predominant pressure ulcer assessment tool used in the UK and Ireland.
Guiding the allocation of pressure-relieving equipment and nursing interventions.
Extensive Scope
While the Braden scale has 6 categories, the Waterlow score encompasses a vast array of physiological factors including BMI, skin type, age, gender, specific neuropathies, and surgical times, making it highly sensitive.
Section 2
Formula & Logic
Scoring
Unlike Braden and Norton, a HIGHER Waterlow score indicates HIGHER risk.
Score 10+ indicates "At Risk".
Score 15+ indicates "High Risk".
Score 20+ indicates "Very High Risk".
Categories Assessed
Build/Weight for Height
Average (0), Above Average (1), Obese (2), Below Average (3)
Tissue malnutrition (Cachexia, Cardiac Failure), Neurological Deficit (MS, Stroke, Paraplegia), Major Surgery (>2 hours)
Section 3
Pearls/Pitfalls
The Surgery Penalty
The Waterlow score uniquely penalises patients who have undergone major surgery (particularly > 2 hours or orthopaedic/spinal surgery), reflecting the immense pressure damage that occurs during prolonged anaesthesia on hard operating tables.
Section 4
Next Steps
Management
Section 5
Evidence Appraisal
Primary Reference
Pressure sores: a risk assessment card.
Waterlow J. • Nurs Times.. 1985;81(48):49-55. The original publication of the tool that became the standard of care across the NHS.
Section 6
Origins
Judy Waterlow
Created by British clinical nurse teacher Judy Waterlow in 1985. She designed it as a comprehensive checklist on a pocket-sized card for nurses, incorporating the clinical reality that pressure ulcers are driven as much by systemic disease and age as by physical immobility.
