Waterlow score Chart
For Hospital Community, Nursing & Residential Home Use
The Waterlow pressure ulcer risk assessment/prevention policy tool is, by far, the most frequently 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 tool.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 scoring system. The reverse side provides guidance on nursing care, types of preventative aids associated with the three levels of risk status, wound assessment and dressings.
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 bed.
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, for example.
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.
Applicability
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 constraints.
