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Validity of Waterlow Scale

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Validity of Waterlow Scale

Sydney nursing school

INTRODUCTION:

Pressure ulcers are areas of localised damage to the skin and underlying tissue caused by pressure. (Stechmiller et al., 2008) Pressure ulcers still one of the most significant health problem in our hospitals today, It affects on patients quality of life patient self-image and how long they will stay in hospital then the cost of patient treatment . Moore (2005) estimate that it costs a quarter of a million euro’s per annum to manage pressure ulcers in hospital and community settings across Ireland .which allows one to take immediate actions and prevent the ulcer if possible. To support pressure ulcer risk assessment several standardized pressure ulcer risk assessment scales have been introduced and their application in clinical practice is recommended (Stechmiller et al., 2008). one of the most common scales used in our hospitals is the Waterlow scale, This scale was designed by Waterlow in 1985, from study in elderly and acute wards (waterlow,1985). The Waterlow Scale assigns believed to predispose patients towards developing pressure ulcers: build/weight, continence, skin type mobility, sex/age, appetite, tissue malnutrition, neurological deficit, surgery/trauma and specific medication. The total scores achieved within each factor are summed to derive the Waterlow score, with higher scores believed to mark greater vulnerability. (Waterlow, 1985) A score of more than 10 is classified as(at risk) between 15 to 20 as (high risk) and more than 20 as (very high risk).

This essay incorporates three major aspects with regards to the waterlow scale in respect to pressure ulcer. These aspects includes the high risk population ,the reliability /validity and advantages and disadvantages of waterlow pressure ulcer scale.

which population(s) the waterlow scale is applicable to?

Waterlow scale one of the famous scales to assess the pressure ulcer. the Waterlow Scale is the most widely used in health care settings



References: Alman, R., Coole, P.S., Patrick, M.M., Burst, N., Bartolucci,A.A., 1995. Pressure ulcer risk factors among hospitalisedpatients with activity limitation. Journal of AmericanMedical Association 273 (11), 865–870. Anthony, D., Barnes, J., & Unsworth, J. (1998). An evaluation of current risk assessmentscales for decubitus ulcer in general inpatients and wheelchair users. Clinical Rehabilitation, 12, 136-142. Anthony, D., Clark, M., Dallender, J., 2000a. An optimisation of the Waterlow score using regression and artificial neural networks. Clinical Rehabilitation 14, 102–109 Anthony, D., Unsworth, J., 1998 Balzer, K., Pohl, C., Dassen, T., & Halfens, R. (2007). The Norton, Waterlow,Braden and Care Dependency Scales: Comparing their validity when identifyingpatients’ pressure sore risk. Journal of Wound Ostomy and Continence Nursing, 34, 389-398. Boyle, M., & Green, M. (2001). Pressure sores in intensive care: Defining their incidence and associated factors and assessing the utility of two pressure sore risk assessment tools. Australian Critical Care, 14(1), 24-30. Bowling, A., 1991. Measuring health: a review of quality of life measurement scales. Open University Press, London. Clark, M., Farrar, S., 1992. Comparison of pressure sore risk calculators. In: Harding, K.G., Leaper, D.L., Turner, T.D. (Eds.), Proceedings of the First International Conferences of Advances in Wound Management. Macmillan, London, pp. 158–161. Cook, M., Hale, C., & Watson, B. (1999). Interrater reliability and the assessment of pressure-sore risk using an adapted Waterlow Scale. Clinical Effectiveness in Nursing, 3(2), 66-74. Edwards, M. (1995). Pressure sore risk calculators: some methodological issues. Journal of Clinical Nursing, 5, 307-312. European Pressure Ulcer Advisory Panel, 1998. Pressure ulcer treatment guidelines (available at: http://www.epuap.org/gltreatment.html). Franks, P. J., Moffatt, C. J., Chaloner, D. (2003). Risk assessment scales poorly predict pressure ulceration. British Medical Journal, 326, 7381, 165. Gould, D., Kelly, D., Goldstone, L., & Gammon, J. (2001). Examining the validity of pressure ulcer risk assessment scales: developing and using illustrated patient simulations to collect the data. Journal Of Clinical Nursing, 10(5), 697-705. Kelly, J. (2005). Inter-rater reliability and Waterlow’s pressure ulcer risk assessment tool. Nursing Standard, 19(32), 86-92. Moore, Z., Jordan-O’Brien, J., & Barrett, S. (2006). Pressure ulcer guidelines: A pocketguide for practice. Dublin, Ireland: Smith and Nephew. O’Tuathail, C., & Taqi, R. (2011). Evaluation of three commonly used pressure ulcer risk assessment scales. British Journal Of Nursing, 20S27-34. Pancorbo-Hidalgo, P. L., Garcia-Fernandez, F. P., Lopez-Medina, I. M., &Alvarez-Nieto, C. (2006). Risk assessment scales for pressure ulcer prevention: asystematic review. Journal of Advanced Nursing, 54(1), 94-110. Pang, S. M., & Wong, T. K. (1998). Predicting pressure sore risk with the Norton,Braden and Waterlow Scales in a Hong Kong rehabilitation hospital. Journal of the Eastern Nursing Research Society and the Western Institute of Nursing, 47, 147-153. Papanikolaou, P., Lyne, P., Lycett, E., 2003. An application oflogistic analysis to investigate pressure ulcer risk assessmentin elderly medical in-patients in a major hospital. Journal ofAdvanced Nursing 44 (2), 1–9. Polit, D. F., Beck, C. T., & Hungler, B. P. (2001). Essentials of nursing research: Methods, appraisal and utilization (5th ed.). Philadelphia, PA: Lippincott. Shukla, V. K., Shukla, D., Singh, A., Tripathi, A. K., Jaiswal, S., & Basu, S. (2008). Risk assessment for pressure ulcer: A hospital-based study. Journal of Wound Ostomy and Continence Nursing, 35, 407-411. Smith, L.N., Booth, N., Douglas, D., Robertson, W.R., Walker, A., Durie, M., Fraser, A., Hillan, E.H., Swaffield, Waterlow, J. (1995) Pressure sores: a risk assessment card. Nurs Times 81(48): 50-55. Thompson, D. (2005). Tissue viability. An evaluation of the Waterlow pressure ulcer risk-assessment tool. British Journal of Nursing, 14, 455-459. Watkinson, C. (1996). Inter-rater reliability of risk-assessment scales. Professional Nurse, 11, 751-756. Waterlow, J., 1985. A risk assessment card. Nursing Times 81 (48), 49–55. Waterlow, J. (2005a). From costly treatment to cost-effective prevention: Using Waterlow Webster, J., Gavin, N., Nicholas, C., Coleman, K., & Gardner, G. (2010). Validity of the Waterlow Scale and risk of pressure injury in acute care. British Journal of Nursing, 19(6), 14-18.

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