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Nursing staff in paediatric intensive care units (PICUs) regularly face a complex combination of nursing problems when admitting critically ill children. The assessment of skin integrity might not always be a priority during the initial period following admission. This article outlines some of the difficulties facing nurses involved in the care of critically ill children and reviews the literature on pressure ulcer assessment, highlighting the lack of a universal tool for risk assessment in this area. It also shows how a simple audit changed practice and reduced the incidence of pressure ulcer development in the PICU of the Royal Belfast Hospital for Sick Children over a two-year period.

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