1. In pre-op: Use the chart below to assess the patient's mobility,
body mass index, NPO status, weight loss, age and comorbidities.
So, for example, if the patient hadn't lost any weight in the 6 months
before surgery, give him a score of 1 in that section. But if he has a
high BMI, low mobility and several comorbidities, he might earn 2s or
3s in those categories, which puts him in the "high risk" range for the
preoperative phase. Share that information with the OR team, who
can then follow best practices for preventing pressure injuries such as
applying a multilayered dressing to the sacrum or using regional anes-
thesia, so the patient can ambulate sooner in PACU.
2. In the OR: Use this chart to assess the physical status, type of anes-
thesia, body temperature, hypotension, moisture, surface/motion and sur-
gical position.
4 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • O C T O B E R 2 0 1 8
Risk Factor 1 2 3 Total
Mobility Not limited Very limited Completely immobile
BMI < 30kg/m² 30kg/m² to 35kg/m² > 35kg/m²
NPO Status 12 hours or less
>12 hours,
< 24 hours
More than 24 hours
Weight Loss
(previous 6 months)
Up to 7.4% weight 7.5% to 9.9% ≥ 10% weight loss
Age 39 years or younger 40 to 59 years 60 years or older
Comorbidities (1 point for each)
Current Smoker
Diabetes
BP levels > 120/80
Vascular disease
Respiratory disease
Pressure ulcer history
5-6 = low risk 7-14 = moderate risk ≥ 15 = high risk Intraop score:
