This paper investigates the predictive power of the Norton score in the problem of anticipating pressure lesions, and looks at some variants on that score. The Norton score is now nearly 20 years old but is still not in frequent use by nurses, and has been the subject of little research, especially in its predictive ability. By following the progress of two matched samples over a 15-month period in a district general hospital it is established that the Norton score does perform at least as well as a number of reasonable variants of it, and that in particular the physical score and incontinence score are the crucial elements. A follow-up sample in which the variants are retested confirms the usefulness of the Norton score.

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This paper summarizes the results of the trial of the Beaufort Bead Bed system designed to reduce the incidence and severity of pressure sores. Elderly orthopaedic admissions were allocated alternately to the Beaufort system and to the usual trolley, table and bed surfaces, and followed from admission to hospital until separation. The incidence of pressure sores was 15.6% in the 32 'trial' patients, which was significantly less than the 48.8% in the 43 'control' patients, as was the mean maximum diameter of the pressure sores incurred: 6.4 mm for the 'trials' as against 29.5 mm for the 'controls'. In particular the trial group were free from pressure lesions to the heel, which affected 32.6% of the control group. The groups were well matched on a variety of criteria on admission, and we conclude that the Beaufort system successfully reduces the incidence and severity of pressure sores for elderly orthopaedic patients. The system--renamed recently the 'Neumark-Macclesfield Support System'--is now in regular and satisfactory use.

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