What is the meaning of Waterlow risk (pressure ulcer risk)?

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Last updated: June 29, 2025View editorial policy

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From the Guidelines

The Waterlow risk assessment is a valuable tool for evaluating a patient's risk of developing pressure ulcers, assigning points based on several risk factors to indicate the level of risk and guide preventive measures. The Waterlow scale is used to assess the risk of pressure ulcers by evaluating factors such as age, skin condition, mobility, nutritional status, continence, and special risk factors like tissue malnutrition or neurological deficits 1. The total score from the Waterlow scale indicates the level of risk, with 10-14 points suggesting "at risk," 15-19 points indicating "high risk," and 20+ points signifying "very high risk" 1.

Key Points to Consider

  • The Waterlow scale helps identify vulnerable patients early, allowing for proactive care planning to prevent pressure ulcers 1.
  • Regular reassessment is necessary as a patient's condition changes to ensure prevention strategies remain appropriate 1.
  • The Waterlow scale is equivalent to clinical judgment alone for reducing pressure ulcer incidence, but it can help in the identification of patients who are at an increased risk for pressure ulcers 1.
  • Preventive measures such as regular repositioning, specialized support surfaces, skin care regimens, and nutritional interventions can be implemented based on the Waterlow score to prevent pressure ulcers 1.

Clinical Application

The Waterlow risk assessment is a useful tool in clinical practice for identifying patients at risk of developing pressure ulcers and guiding preventive measures to reduce the incidence of these painful and potentially serious wounds 1. By using the Waterlow scale, healthcare providers can implement targeted interventions to prevent pressure ulcers and improve patient outcomes 1.

From the Research

Waterlow Risk Meaning

The Waterlow risk refers to the likelihood of a patient developing pressure ulcers, as assessed by the Waterlow pressure ulcer risk-assessment tool 2, 3. This tool is widely used in the UK and other countries to identify patients at risk of developing pressure ulcers.

Key Factors

The Waterlow risk assessment scale takes into account various factors, including:

  • Continence
  • Skin condition
  • Mobility
  • Inter-hospital transfer
  • Poor nutrition
  • Skin type 2, 4

Reliability and Validity

Studies have evaluated the reliability and validity of the Waterlow scale, with mixed results. Some studies have found that the scale has satisfactory predictive ability 2, while others have raised concerns about its inter-rater reliability and agreement 4.

Clinical Application

The Waterlow scale is commonly used in clinical practice to assess patients' risk of developing pressure ulcers 5. However, it is essential to use the scale in conjunction with clinical judgment, as over-predicting pressure ulcers is a common problem 6.

Importance of Education and Training

Ongoing education and training are crucial for healthcare professionals to accurately assess patients' risk of developing pressure ulcers and to prevent and manage these conditions effectively 5, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

An evaluation of the Waterlow pressure ulcer risk-assessment tool.

British journal of nursing (Mark Allen Publishing), 2005

Research

Evaluation of three commonly used pressure ulcer risk assessment scales.

British journal of nursing (Mark Allen Publishing), 2011

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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