The Waterlow score (or Waterlow scale) gives an estimated risk for the development of a
pressure sore
Pressure ulcers, also known as pressure sores, bed sores or pressure injuries, are localised damage to the skin and/or underlying tissue that usually occur over a bony prominence as a result of usually long-term pressure, or pressure in combi ...
in a given patient. The tool was developed in 1985 by clinical nurse teacher
Judy Waterlow. It is available both on a two-sided score card and on an app.
Scoring criteria
The following areas are assessed for each patient and assigned a point value.
*Build/weight for height
*Skin type/visual risk areas
*Sex and age
*
Malnutrition Screening Tool
*
Continence
Continence may refer to:
*Fecal continence, the ability to control defecation, see Fecal incontinence
*Urinary continence, the ability to control urination, see Urinary incontinence, the involuntary excretion of urine
*Sexual continence, a synony ...
*Mobility
Additional points in special risk categories are assigned to selected patients.
*Tissue malnutrition
*
Neurological deficit
Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal c ...
*Major
surgery
Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...
or
trauma
Trauma most often refers to:
* Major trauma, in physical medicine, severe physical injury caused by an external source
* Psychological trauma, a type of damage to the psyche that occurs as a result of a severely distressing event
*Traumatic i ...
Potential scores range from 1 to 64.
[Waterlow Score - Tool Evaluation: Melbourne Health]
/ref> A total Waterlow score ≥10 indicates risk for pressure ulcer
An ulcer is a discontinuity or break in a bodily membrane that impedes normal function of the affected organ. According to Robbins's pathology, "ulcer is the breach of the continuity of skin, epithelium or mucous membrane caused by sloughing o ...
. A high risk score is ≥15. A very high risk exists at scores ≥20. The reverse side of the Waterlow card lists examples of preventive aids and interventions.
Criticism
While packaged conveniently as a laminated card, the score has received criticism owing to its large number of scored items. This, combined with a lack of operational definition
An operational definition specifies concrete, replicable procedures designed to represent a construct. In the words of American psychologist S.S. Stevens (1935), "An operation is the performance which we execute in order to make known a concept." F ...
s, may reduce its reliability
Reliability, reliable, or unreliable may refer to:
Science, technology, and mathematics Computing
* Data reliability (disambiguation), a property of some disk arrays in computer storage
* High availability
* Reliability (computer networking), a ...
.[
]
See also
* Braden Scale for Predicting Pressure Ulcer Risk
References
{{reflist
Nursing
Skin conditions resulting from physical factors
Medical scoring system