for caregivers is critical to the success of any pressure ulcer prevention program. Physicians, nursing personnel, and other hospital caregivers need to clearly understand the need for and reasons underlying protocol changes. Education should address the etiology of hospital-acquired pressure ulcers, risk factors, prevention strategies, documentation, identification and staging, and wound management.33 Training that is frequent and ongoing and that includes quality improvement evaluations of bedside practices is vital to program sustainability.6 For example, at NHCH, skin assessments were observed by the shift-nurse-in-charge, with immediate feedback given if an assessment was inadequate