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* Objective: This study explored whether the risk assessment method, structured versus clinical judgment, influences pressure ulcer (PU) prevalence or prevention strategies. * Method: A cross section survey design was employed with use of a pre-designed data collection instrument. Following ethical approval and consent, data was gathered from two acute care settings, one in Norway (clinical judgment) and one in Ireland (structured risk assessment using the Maelor Score). * Results: Data were obtained from 180 patients, 59 in Norway and 121 in Ireland. Of the patients 48% were male and 49% were female, gender was not recorded for 3%.The most common age bracket was 70-99 years of age, 46% of the study population. PU prevalence was 54% in the Norwegian site with the majority of PUs (69%) being category I, and 12% in the Irish site with the majority (50%) being category 2. Only 8% of patients in the Norwegian site were risk assessed on admission compared with 85% in the Irish site. No dynamic mattresses and four pressure redistribution cushions were in use in the Norwegian site, whereas, in the Irish site, 27 dynamic mattresses and II pressure redistribution cushions were used, the majority (44%) for high-risk individuals. Of those at risk of PU development, 15% in the Norwegian site and 56% in the Irish site had a documented repositioning care plan when in bed,and 0% in the Norwegian site and 13% in the Irish site for when seated on a chair. * Conclusion: There were inconsistencies in approach to PU risk assessment and prevention across the two clinical settings. However, prevalence rates differed, mainly relating to category I PU damage. Even though formal risk assessment is well established in the Irish site, this is not necessarily followed up with appropriated PU prevention. Thus, the method of risk assessment does not seem to influence subsequent care planning, questioning the role of formal risk assessment; however, despite this, risk assessment does put a focus on an important clinical problem. In the Norwegian site, a lack of risk assessment and appropriate equipment may be a confounding factor worthy of further exploration. * Declaration of interest: This work is partly funded by a research grant from the Norwegian Nurses Organisation (Norsk Sykepleierforbund NSF).The authors have no conflict of interest to declare. [ABSTRACT FROM AUTHOR]

• Objective: To explore similarities and differences in nurses’ views on risk assessment practices and preventive care activities in a context where patients' risk of developing pressure ulcers is assessed using clinical judgment (Norway) and a context where patients’ risk of developing pressure ulcers is assessed using a formal structured risk assessment combined with clinical judgement (Ireland). • Method: A descriptive, qualitative design was employed across two different care settings with a total of 14 health care workers, nine from Norway and five from Ireland. • Results: Regardless of whether risk assessment was undertaken using clinical judgment or formal structured risk assessment, identified risk factors, at risk patients and appropriate preventive initiatives discussed by participant were similar across care settings. Furthermore, risk assessment did not necessarily result in the planning and implementation of appropriate pressure ulcer prevention initiatives. Thus, in this instance, use of a formal risk assessment tool does not seem to make any difference to the planning, initiation and evaluation of pressure ulcer prevention strategies. • Conclusion: Regardless of the method of risk assessment, patients at risk of developing pressure ulcers are detected, suggesting that the practice of risk assessment should be re-evaluated. Moreover, appropriate preventive interventions were described. However, the missing link between risk assessment and documented care planning is of concern and barriers to appropriate pressure ulcer documentation should be explored further. • Declaration of interest: This work is partly funded by a research grant from the Norwegian Nurses Organisation (NNO) (Norsk Sykepleierforbund NSF) in 2012. The authors have no conflict of interest to declare. [ABSTRACT FROM AUTHOR]