Pressure ulcers are one of the most commonly encountered problems in hospital yet can produce serious effects. The Braden Scale is known to be a highly reliable assessment tool but is normally just used on admission. The population consisting of surgical patients and other patients on prolonged bed rest requires ongoing and periodic skin assessment. The intervention should be continued use of the Braden scale. The usual comparison intervention occurs only when a pressure ulcer actually appears. The policy involves ongoing use of the Braden Scale at specific points during hospitalization, and especially two days post-op for surgical patients and then at set points. The policy is important for continuity of care and uniformity of practice since many nurses are following what they consider to be most effective. Awareness of best practice is lacking. The policy includes consistent use of the Braden Scale, staff education related to use, interpretation, and documentation of the scale. Education also will pertain to incidence and contributing factors to pressure ulcer development with a focus on older and surgical patients. The policy will be a two-year program, and all surgical and older patients will benefit. Xakellis and Frantz (2001) demonstrate in their study why it is important to place a limit on a policy or program. They found that their implementation of a guideline based pressure ulcer prevention program protocol initially caused a reduction in the problem but then the outcomes gradually and steadily deteriorated. The outcomes will be a very significant reduction in the incidence of pressure ulcers on the unit. Other major outcomes will be a changed nursing culture along with patient-centered practice and a holistic approach. Introduction Pressure ulcers comprise a rather common health issue that can prove very serious for certain patients, and the incidence of pressure ulcers is taken as a measure of quality patient care (Hobbs, 2004; Shewchuk, Padula & Osborne, 2006). This paper will emphasize the importance of Braden Scale assessment and why it must be used at specific point beyond admission. Patients undergoing surgery are at high risk for developing pressure ulcers even though they initially exhibit low preoperative Braden Scale risk scores (Shewchuk, et al). According to Fisher, Wells & Harrison (2004), the Braden Scale was initially tested on hospital populations and intensive care units and valuated as being highly reliable. A focus on Braden Scale assessment in itself can be misleading since it cannot replace clinical judgment (Thompson, 2005) and tools other than the Braden scale are needed to identify nutritional risks which interfere with pressure ulcer prevention and healing (Sezginsoy, Teasdale, Wright & Bernard, 2004). A policy needs to be developed to ensure that nurses not only complete the Braden Scale on admission, but complete it at established points in order to identify patients who are at risk for developing a pressure ulcer. Background The current practice is to perform Braden Scale assessment only on admission in the absence of a pressure ulcer, the Braden scale is not completed. This practice actually conforms to RNAO (2007) guidelines which stipulate that a physical and psychosocial assessment should be conducted; pain and nutrition must be assessed. All patients with existing pressure ulcers should be assessed for their risk of further pressure sore development by use of the Braden Scale and vascular assessment (RNAO). The problem with this practice is that patients who are at risk for pressure sore development are not being screened. By reducing the incidence of pressure ulcers, we can significantly reduce healthcare costs. According to Shewchuk, et al. (2006), the cost of treating pressure ulcers can range from $5000 to $40,000. Thompson (2005) states that the costs associated wit