Waterlow score

The Waterlow score (or  Waterlow scale) gives an estimated risk for the development of a pressure sore 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
 * Mobility

Additional points in special risk categories are assigned to selected patients.


 * Tissue malnutrition
 * Neurological deficit
 * Major surgery or trauma

Potential scores range from 1 to 64. A total Waterlow score ≥10 indicates risk for pressure ulcer. 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 definitions, may reduce its reliability.