The correlation between risk factors and the development of pressure ulcers is still a topic of great concern for most nursing facilities. It still remains unclear which, if any, pressure ulcers could have been prevented and what exactly could have been done to prevent their occurrence. As legal action has become a growing concern, it is important for nursing facilities to document all preventative measures. There are steps that should be taken to prevent pressure ulcers, while also protecting staff should an unavoidable ulcer occur. 
Surveillance. At the time of admission, and when there are changes in the patient’s status, nurses must use an appropriate risk assessment tool for pressure ulcer development. While most cases occur within the first 2 weeks of hospitalization, a patient’s risk profile can change over time. Wound assessments should be done regularly.
Prevention. Evidence-based interventions should be used to prevent pressure ulcers in vulnerable patients. However, a patient has a right to refuse treatment. If preventative measures are refused, it is very important that this is documented.
Patient/family involvement and education. Involving and educating the patient and family or other caregivers is key to providing quality care. The pressure ulcer in particular is a concept that is often difficult for patients and family members to understand. Any educational tools provided to the family should be documented.
Protecting caretakers. Documentation is the most powerful tool a caretaker has to protect themselves. Wound assessment documentation is the foundation of both fiscal responsibility and legal protection. Detailed documentation of the steps taken to prevent an unavoidable pressure ulcer can also help reduce any anger and blame that the family may feel. For more information on ways to manage and document wound care, visit woundrounds.com.
 Stokowski, Laura A. “The Unavoidable Pressure Ulcer: Dilemmas Faced by Nursing Staff.” Medscape.org. Web. 11 March 2010.