title: Is pressure ulcer prevention given the priority it deserves?
abstract: In England, the Chief Nursing Officer of the Department of Health has raised the stakes with regard to pressure ulcer prevention, by putting it into the 'high impact actions' arena. It is probably true to say that this has prompted a flurry of activity around 'Root Cause Analysis' of incidents of pressure damage. The process involves senior nurses, and possibly risk managers, investigating why patients developed category three and four ulcers. There will have been recurrent themes, such as failure to check the patient's skin or pressure ulcer risk on admission to professional care. If such checks are not carried out, there is no baseline from which real causation can be deduced.
authors.forename: Miles
authors.initials: M
authors.lastname: Maylor
mesh_terms: D006801:Humans; D003668:Pressure Ulcer / Q000517:prevention & control*; D011787:Quality of Health Care; D012308:Risk Management; D006113:United Kingdom