Further consideration should be given to the importance of place when both developing risk management strategies for pressure ulcer prevention and learning the lessons from failure.

The execution and incorporation of research into practice is in uenced by the relevance and credibility of the work undertaken. Part of this process can be to identify priority research questions from the service provider perspective. We sought to obtain a multidisciplinary consensus on priority research questions around the broad issue of prescribing in an inner London Primary Care Group locality. Participants were drawn from general practice, primary care nursing and community pharmacy. This paper explores how two formal consensus methods were used to facilitate multidisciplinary participation within the research arena, and the extent to which a convergence of opinion between professional groups was obtained. The use of a structured nominal group interview technique abated professional dominance and generated a diverse array of research questions. An iterative Delphi process secured a wide consensus of opinion regarding the relevance of these questions to practice. The richness of the research questions generated was attributed to the consultation process and the ability of the consensus methods used to capture the multidisciplinary perspective. The practice based research questions identi ed were diverse and suited to a collaborative research approach.

Background: The assessment of capacity to consent to treatment is key to

Pressure ulcer reduction is a healthcare priority. Good clinical guidelines have the potential to transform pressure ulcer prevention and management practices. However, evidence suggests these guidelines are inconsistently utilised. The aim of this study was to explore health practitioners' perceived barriers and enablers to the implementation of evidence-based pressure ulcer prevention and management recommendations in an integrated community care setting. The study used a qualitative exploratory design. It took place in a community Trust in London, England. Semistructured interviews were conducted with a purposive sample of registered nurses and allied healthcare professionals (AHPs). The Theoretical Domains Framework (TDF) informed both data collection and data analysis. Analysis followed a five-step process including deductive coding of the transcripts and inductive generation of specific belief statements. Nine nurses and four AHPs took part in the study. Six TDF domains were identified as most relevant to the implementation of best practice in pressure ulcer prevention and management: Goals, Knowledge, Skills, Beliefs about capabilities, Environmental context and resources and Social influences. All participants felt it was important to prevent pressure ulcers and were motivated to do so. Key enablers to the implementation of evidence-based practice included high levels of self-reported pressure ulcer knowledge and skills (nurses), responsive community equipment provision, the introduction of novel Pressure Ulcer Implementation Facilitator roles and integrated team working. Barriers included self-reported deficits in knowledge and skills (AHPs), worries about inspecting intimate anatomical locations (AHPs), difficulties initiating conversations with patients about risk and behaviour change, high workloads and clutter in the home. Family members and mobile working solutions were identified as both enablers and barriers. Potential routes to addressing implementation challenges are identified and recommendations made for future research.

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