Abstract: Explains the implications of pressure injuries as an indicator of quality of care and how the Waterlow scale is used in international guidelines for prevention of such injuries. Explores the effectiveness and validity of the Waterlow scale in acute care settings for the prevention of pressure injuries by means of a synthesis of the information from 11 studies examining the validity, reliability, feasibility and cost implications of using the Waterlow scale. Recommends its use in conjunction with clinical judgement.