⚕️ For clinical reference only. Not a substitute for professional judgment.

Waterlow Score Pressure Ulcer

Waterlow pressure ulcer risk assessment — identifies patients requiring preventive interventions. Widely used in UK NHS inpatient settings.

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Complete all sections

Score each section to calculate overall pressure ulcer risk.

Build & Weight

Skin Type

Sex & Age

Mobility

Continence

Nutrition

Special Risk Factors (tick all that apply)

Tissue malnutrition (terminal cachexia, cardiac failure, anaemia, smoking, PVD) +8 Neurological deficit (MS, CVA, motor/sensory paraplegia, diabetes) +6 Major surgery / trauma: orthopaedic or spinal >2 hrs on table +8 Medications: steroids, cytotoxics, high-dose anti-inflammatory +4

Risk Thresholds

Score 10–14: At risk → Preventive measures Score 15–19: High risk → Active prevention protocol Score 20+: Very high risk → Maximum prevention + specialist review

When to use

All inpatients on admission — NICE QS89 mandates risk assessment within 6 hours
Reassess after any change in clinical condition or surgery
Score ≥10: pressure-relieving mattress, regular repositioning, skin care protocol
Score ≥20: consider specialist tissue viability nurse referral

References

Waterlow J. Pressure sores: a risk assessment card. Nursing Times. 1985;81(48):49–55.
NICE QS89. Pressure ulcers. 2015.