Waterlow Pressure Ulcer Risk Score
Waterlow pressure ulcer risk score (1985, revised 2005): build, skin, sex and age, malnutrition screening, continence, mobility and special risks. 10+ at risk, 15+ high risk, 20+ very high risk.
Score interpretation
Waterlow score below the 'at risk' threshold of 10.
→ Reassess if the patient's condition changes.
Waterlow 10–14: at risk of pressure ulcers.
→ Skin assessment; encourage (or help) repositioning at least every 6 hours; high-specification foam mattress if admitted to hospital (NICE CG179).
Waterlow 15–19: high risk of pressure ulcers.
→ High-specification foam mattress; encourage (or help) repositioning at least every 4 hours; heel offloading; nutrition assessment (NICE CG179).
Waterlow 20 or more: very high risk of pressure ulcers.
→ As for high risk, with tissue viability specialist input and review of the support surface.
Interpretation bands for the Waterlow. Apply clinical judgement and local guidance.
References
- Waterlow J. Pressure sores: a risk assessment card. Nursing Times. 1985;81(48):49-55 (score card revised 2005).
- NICE CG179. Pressure ulcers: prevention and management. 2014.
Related
Curated clinical cross-links plus same-class fallbacks.
- Chlorhexidine gluconate with isopropyl alcohol · Skin antiseptic
- Chlorhexidine with cetrimide · Skin antiseptic / wound cleanser
- Barrier creams and ointments · Topical skin protectant
- Chlorhexidine · Antiseptic / disinfectant (bisbiguanide)
- Cefalexin · First-Generation Cephalosporin — Skin / Soft Tissue / UTI
- Palivizumab · RSV Prophylaxis — Monthly Monoclonal Antibody (High-Risk Infants)
- Sepsis Screening and Sepsis Six · UK Sepsis Trust; NICE NG51; Surviving Sepsis Campaign 2021
- Unintentional Weight Loss Workup · NICE NG12; BSG
- Chronic Fatigue Workup · NICE NG206; BMJ Best Practice
- Lymphadenopathy Workup · NICE NG12; BMJ Best Practice
- Pre-op Medical Clearance · NICE NG45; ESC 2022
- Secondary Hypertension Workup · NICE NG136; ESH 2023
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.