Heather Orsted, University of Toronto, Canada, discusses the reasons for developing The Pressure Ulcer Awareness and Prevention (PUAP) Program, which is funded by the CAWC. This is a continuous quality improvement programme that has been built on a strong foundation of adult learning principles as well as the evidence presented by the Registered Nurses' Association of Ontario (RNAO), pressure ulcer assessment by the National Pressure Ulcer Advisory Panel (NPUAP) and risk assessment by Braden. The ultimate goal of the PUAP Program is to create a culture shift from treating pressure ulcers to preventing pressure ulcers.