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The Norton Scale is used to assess the risk of developing pressure ulcers. The Norton Scale was developed by Doreen Norton, who was a nurse specialized in geriatric (elderly) nursing.
History of the Norton Scale
The Norton scale was created in the 40s. It was created by a British nurse, Doreen Norton, who drew attention to the problem of proper and regular care for bedsores, especially in elderly patients. Norton has developed a scale that assesses a person’s risk of developing pressure ulcers and provides effective ways to prevent and care for them if they do occur.
Points on the Norton scale – how to use the Norton scale
There is a risk of pressure ulcers for anyone who is bedridden after surgery or who is in a wheelchair.
This risk increases especially in the elderly, when it is possible that their condition will gradually deteriorate rather than improve.
The Norton scale assesses from 1 to 5 patient conditions: physical condition, state of consciousness, activity and the ability to independently change the position and function of the anal sphincters and urethra. The maximum number of points on the Norton scale is 20. Below 14 points there is a risk of pressure ulcer which increases with decreasing number of points.
The Norton Scale takes into account the following risk factors:
- Physical condition: it can be rated as good (4 points), fairly good (3 points), average (2 points), very severe (1 point);
- State of consciousness: full consciousness and awareness – 4 points, apathy – 3 points, disturbance of consciousness – 2 points, stupor or coma – 1 point;
- Activity (ability to move): walks alone – 4 points, walks with assistance – 3 points, only wheelchair access – 2 points, constantly stays in bed – 1 point;
- The degree of independence when changing positions: full – 4 points, limited – 3 points, very limited – 2 points, complete disability – 1 point;
- Anal and urethral sphincter function: full sphincter efficiency – 4 points, occasional wetting – 3 points, usually incontinence – 2 points, complete failure to obtain stools – 1 point.
When is the Norton scale used?
The Norton Scale can be used in any patient after surgery or during the period of illness. It is especially useful in medical care facilities and in retirement homes to assess the risk of developing pressure ulcers in a given person. According to the result obtained in the Norton scale, remedial measures are used (mattresses, frequent changes of position, lubrication of the patient’s skin with appropriate preparations) and the patient’s condition is monitored.
Other scales for assessing the patient’s condition
In addition to the Norton Scale, other patient care scales are also used in patient care. They are the Barden scale, the Waterloo scale, and the CBO scale. They are used to evaluate other parameters, but also provide information on the risk of developing pressure ulcers in a patient.