The Waterlow pressure ulcer risk assessment/prevention policy
tool is, by far, the most
used system in the U.K. and it is also the most easily understood
and used by nurses dealing directly with patient/clients.
Intended for use by nurses, healthcare professionals and
carers at the patient/client interface.
It must be remembered that "Waterlow",
like all risk assessment scoring systems is a simplistic
Professional judgement must be used in determining the risk
status of the patient/client.
All assessments and, just as importantly, reassessments
must be documented and the plan of care adjusted as necessary.
The Waterlow Manual provides comprehensive
guidance on the use of the Waterlow scoring system.
One side illustrates the risk assessment . The reverse side provides
guidance on nursing care, types of preventative aids associated
with the three levels of risk status, wound assessment and
When the Waterlow card is being used in the Community or
in the Nursing and Residential homes it is vital to recognise
that this environment is markedly different from the one
in which the scoring system was developed.
The risk factors are still the same, but can be alleviated
by the client having for example:
A) A good quality mattress, duvet for his/her
B) A good quality armchair to sit out in.
C) A caring relative or friend who keeps
a constant eye on them and provides good nutritious meals,
These factors raise the risk threshold so that if a person
is discharged from Hospital with a stated ‘Waterlow
score’ this score must be reviewed in the
light of the changed circumstances to determine the requirements
of the clients.
By working in this manner and using the same assessment
system in all areas of care, the patient can receive ‘seamless
care’ as they move to and fro between Hospital, nursing/residential
homes, or their own home.
The Waterlow card is applicable to all areas of care, from
A&E to Residential Nursing Homes.
It is however a simplistic tool, and it is the responsibility
of assessors to use the risk assessment system and the advice
on the selection of preventative aids, in conjunction with
their own expertise and their own area of care’s specific
For more information
Click Here to visit the Waterlow Card Download page.