Validity of the Waterlow scale and risk of pressure injury in acute care

Webster, Joan, Gavin, Nicole, Nicholas, Catherine, Coleman, Kerrie and Gardner, Glenn (2010) Validity of the Waterlow scale and risk of pressure injury in acute care. British Journal of Nursing, 19 S6: S14-S22.

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Author Webster, Joan
Gavin, Nicole
Nicholas, Catherine
Coleman, Kerrie
Gardner, Glenn
Title Validity of the Waterlow scale and risk of pressure injury in acute care
Journal name British Journal of Nursing   Check publisher's open access policy
ISSN 0966-0461
Publication date 2010-01-01
Sub-type Article (original research)
Volume 19
Issue S6
Start page S14
End page S22
Total pages 9
Place of publication London, United Kingdom
Publisher M A Healthcare
Language eng
Subject C1
920203 Diagnostic Methods
111702 Aged Health Care
Formatted abstract
Aim: To assess the validity of the Waterlow screening tool in a cohort of internal medicine patients and to identify factors contributing to pressure injury.
Method: A longitudinal cohort study design was used. A total of 274 patients (mean age 65.3 years) admitted through the emergency department or outpatient clinics of a tertiary hospital in Brisbane, Australia, and expected to remain in hospital for at least 3 days were screened on admission using the Waterlow screening tool. Their pressure ulcer status was monitored and recorded every second day. The main outcome measure was pressure ulcer incidence.
Results: Fifteen participants (5.5%) had an existing pressure ulcer and a further 12 (4.4%) developed a pressure ulcer during their hospital stay. Sensitivity of the Waterlow scale was 0.67 (95% confidence interval [CI]: 0.35-0.88), specificity was 0.79 (95% CI: 0.73-0.85), positive predictive value was 0.13 (95% CI: 0.07-0.24) and negative predictive value was 0.98 (95% CI: 0.94-0.99).
Conclusion: This study provides further evidence of the poor predictive validity of the Waterlow scale. A suitably powered, randomized controlled trial is urgently needed to provide definitive evidence about the usefulness of the Waterlow scale compared with other screening tools and with clinical judgment.
Keyword Waterlow scale
Pressure injury
Acute care
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Nursing, Midwifery and Social Work Publications
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Created: Thu, 27 May 2010, 23:28:23 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work