A escala de Waterlow na úlcera por pressão em pessoas com lesão medular: uma tecnologia assistencial de enfermagem. Waterlow’s Scale on pressure ulcers. PDF | OBJETIVO: Comparar las escalas de riesgo para úlcera por presión de Norton, Braden y Waterlow entre pacientes en estado crítico. MÉTODOS: Estudio . To evaluate the association between the scores of the Waterlow, .. da concordância na aplicação da Escala de Braden interobservadores.

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An absence of studies that address the problems related to extrinsic factors can still be observed, considering that the use of quality indicators revealed by the use of scales does not preclude the use of good nursing practices, regarding special care with change of decubitus, with the skin, with the angle of the patient in the bed, how the patient is maneuvered, with the systematic change of the diaper of the patient, especially those that require more than five changes of the diaper within 24 hours, with the use of pads, that is, the use of the therapeutics emphasizing preventive actions 6.

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The establishedtime to the patients monitoring on days made itimpossible to follow-up the injuries outcome, as wellas the patients healing or the enlargement of theirhospitalization period. Journal List Open Nurs J v.

In this unit, pressure ulcers have an incidence of Am J Crit Care. Nursing care can improve patient safety care and reduce hospitalization costs.

Waterlow score – Wikipedia

The Waterlow scale showed higher scores in the risk assessment for pressure ulcers in relation to the Norton and Wxterlow scales. Limitations The present study has some limitations. Services on Demand Journal. Mainly because these instruments were madefor populations that are different from the Brazilian onesand it is always possible that their limitations are noticedin the hospital everyday life.

Open in a separate window. A comparisonof escla ulcer prevalence concerted data collection inthe Netherlands and Germany. Age, smoking status, diabetes and hypertension were associated with scores on the Waterlow, Braden and Norton scales. Risk assessment for pressure ulcer in critical patients.

A escala de Waterlow aplicada em pessoas com lesão medular

Moreover, the smaller the final sum is, higher is the risk of developing PU Inaddition, the results reinforced the existing directcorrelation between Braden and Norton scales, highlighted by other publications. There are several criticisms concerned to the Norton, Braden, Waterlow and Gosnell risk scales, because some of them underestimate and other overestimate the assessment of at-risk patients.


Risk assessment scalesfor pressure ulcers: The higher the score, the higher the risk of developing pressure ulcers, with patients also stratified into risk groups according to the score Altogether, patients have had 47 PU at differentlocations and stages, with an average of 1.

An exploratory and longitudinal study covering 42 patients who were evaluated for 15 days or at least 10 consecutive days, in three intensive care units within Fortaleza, Brazil, from March to July Another limitation is the use of scales Waterlow and Braden with results dichotomized into high and low risk, which may have caused bias in the research.

Thus, it’s notorious the necessity ofstudies which evaluate instruments, techniques andproducts used to prevent PU, which can be adapted toseveral health service scenarios.

Pressure Ulcer Risk Evaluation in Critical Patients: Clinical and Social Characteristics

Published online Watsrlow After the calculus process, it was identified a sample of 42 patients tocompose the study population. Watsrlow that separately analyzed the Braden and Waterlow scales, also with critically ill patients, observed different sensitivities and specificities between them 101218 – Considering that the ROC curve is a graphical representation of the true positive values sensitivity on the ordinate and the false positive values specificity on the abscissa as a function of each cutoff point, the evaluation of the curve dw the Waterlow scale showed that it was better for predicting patients at risk for pressure ulcers Figure 2.

This finding confirms the study assumptions. Among the existing scales, Braden is the most cited escapa the literature [ 13 ] and is recommended by the Ministry of Health protocol for pressure ulcer prevention [ 23 ]. The evaluation of the accuracy of the scales was performed through the calculations of the diagnostic test properties, sensitivity, specificity, positive predictive value, negative predictive value, the likelihood ratio for a positive test and likelihood ratio for a negative test.

Waterlow score

Ulcers are classified into six categories: Another foreign publication dde identified theWaterlow scales as the one with better sensibility whencompared to Braden and Norton scales, and the bestspecificity was given to Norton scale An early and regular stratification of the risk ofdeveloping a PU is essential to adopt adequate preventivemeasures on an appropriate therapeutic strategyimplementation.

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However, knowledge about risk factors is necessary to recognize and direct nursing actions to prevent PUs [ 12 ].

Lower rates are, however, presented in international studies, highlighting the importance of the prevention and monitoring of this injury 4 – 5. Even though, nurses at theseinstitutions need to identify and understand each medicalspecialty and the PU risk correlations, in order to act onthe intrinsic and extrinsic factors related to PU. The four parameters sum resulted in a score whichvaried from 5 to 20 points, understood like this: ROC curves for the cutoff scores of the Waterlow scale with critically ill patients, according to the evaluation.


This is an open access article distributed under the terms of the Creative Commons Attribution 4. Diabetes, another indicator associated with the Waterlow scale, is prevalent in 6. Hypertension was present in The Braden Scale assesses the sensorial perception,humidity, activity, mobility, nutrition, friction and shear.

The population was constituted by patients interned in Infirmaries: The Waterlow scale assesses seven main topics: In the end, the authors’critical judgment has showed Braden and Norton scalesas presenting better results, fact that is different fromwhat was found out in our study All ethical recommendations were followed during the research stages.

PUs increase the period of hospitalization and the costs of treatment due to the resulting complications [ 6 ]. In clinical practice, these instruments are valid to highlight the vulnerable aspects, to reinforce the need for continuous evaluation and to stimulate prevention, however, these instruments should be tested in the populations in which they will be used and should be applicable to the performance scenario 5.

The assumption of this study is that individuals with hypertension, diabetes, advanced age and smokers have the highest risk of developing pressure ulcers. Out of the 42 assessed patients, 25 developed PUevidencing an incidence of Table 1 – Results of diagnostic tests applied to the cutoff scores of the Waterlow scale, according to the waetrlow.