title: Norton, Waterlow and Braden scores: a review of the literature and a comparison between the scores and clinical judgement.
abstract: OBJECTIVE
  To consider the validity and reliability of risk assessment scales for pressure ulcers.
  
  
  BACKGROUND
  Pressure ulcers are a major problem worldwide. They cause morbidity and lead to mortality. Risk assessment scales have been available for nearly 50 years, but there is insufficient evidence to state with any certainty that they are useful.
  
  
  METHODS
  A literature review and commentary.
  
  
  METHODS
  Bibliographic databases were searched for relevant papers, a critical review was completed on relevant papers.
  
  
  RESULTS
  There is contradictory evidence concerning the validity of risk assesment scales. The interaction of education, clinical judgement and use of risk assessment scales has not been fully explored. It is not known which of these is most important, nor whether combining them results in better patient care.
  
  
  CONCLUSIONS
  There is a need for further work. A study exploring the complex interaction of risk assessment scales, clinical judgement and education and training is introduced.
  
  
  CONCLUSIONS
  Nurses may be wasting their time conducting risk assessment scoring if clinical judgement and/or education are sufficient to assess pressure ulcers risk.
authors.affiliation: Mary Seacole Research Centre, De Montfort University, Leicester, UK. danthony@talktalk.net
authors.forename: Denis
authors.initials: D
authors.lastname: Anthony
authors.forename: Sam
authors.initials: S
authors.lastname: Parboteeah
authors.forename: Mohammad
authors.initials: M
authors.lastname: Saleh
authors.forename: Panos
authors.initials: P
authors.lastname: Papanikolaou
mesh_terms: D006801:Humans; D003668:Pressure Ulcer / Q000451:nursing / Q000473:pathology*; D015203:Reproducibility of Results