Evaluation of three commonly used pressure ulcer risk assessment scales

Pressure ulcers are a huge concern for health professionals, cause suffering to patients and are associated with increased morbidity.

This literature review provides an overview of the literature on the three most commonly used pressure ulcer risk assessment scales-the Waterlow scale, the Braden scale and the Norton scale.

A search was undertaken through the databases CINAHL, MEDLINE, British Nursing Index, ProQuest and Cochrane Library. Key terms included pressure ulcers, pressure sores, risk assessment, Braden scale, Norton scale and Waterlow scale.

While risk assessment scales are beneficial they should not be used without the aid of nurses' clinical judgment. Over-predicting pressure ulcers is a common problem when using risk assessment scales. However, ethical considerations preclude investigation into the predictive capacity of a scale. Ongoing education in the prevention and management of pressure ulcers is essential for nurses. Risk assessment scales should be adapted to suit the needs of the clinical setting in which they are used.

The Waterlow scale is the most widely used risk assessment scale in the UK and Ireland, even though there is no evidence to suggest it is more effective than the other most commonly used scales.