Most pressure ulcers (PUs) are preventable. However, PUs exist all over the world and clinical PU prevention practices vary widely. PUs cause suffering for patients, poses challenges to care for organisations, and cause costs for society.

The aim of this study was to develop, implement and evaluate the effectiveness of a Consistent Practice Intervention based on international PU prevention guidelines in long-term older people care (LOPC). The ultimate goal was to produce a transferable PU prevention intervention to improve the quality of care in LOPC facilities.

In the first phase of the study, a systematic review with structured narrative synthesis was conducted in studies (n = 18) from 2005–2017 to map existing literature regarding the effectiveness of earlier interventions aimed at preventing PUs in LOPC, with comparator usual care. In the second and third phase of the study, the Consistent Practice Intervention was developed, implemented and evaluated using OMEBP model. A quasi-experimental intervention study design in LOPC setting was used. Two chosen facilities were randomly allocated into intervention and comparison facilities (facility as randomisation unit). Altogether, 232 residents (91%) (n = 115 in intervention facility/n = 117 in comparison facility) and 141 RNs and PNs (88%, n = 69/72) participated in the study.

Earlier effective interventions reducing the incidence or prevalence of PUs in LOPC were repositioning, nutrition, advanced mattresses, overlays or cushions, use of electronic support in decision-making and PU prevention bundles or programmes. The Consistent Practice Intervention, i.e., a bundle of six PU prevention areas, reduced the number (p = 0.027) and severity (p = 0.020) of PUs, improved the use of risk assessment (p < 0.001) and nutrition assessment instruments (p < 0.001), increased consistency in nursing staff’s practice for PU prevention in PU risk assessment (p < 0.001) and nutrition (p < 0.001) and improved nursing staff’s PU prevention knowledge in PU risk assessment (p=0.11).

In order for the prevention of PUs to be effective, the Consistent Practice Intervention for PU prevention for nursing staff developed in this study could be a solution to implement evidence-based working methods successfully, ensuring PU prevention to improve the quality of care of older people in LOPC facilities