There is a mismatch between the high prevalence and costs associated with pressure ulcers and the amount of high quality research focussed on their prevention. A simple literature search produces few ‘hits’ suggesting that this is a subject not considered as mainstream. As a topic, it is normally not taught in medical school and unfortunately, does not generate enough interest in medical journals. Although, pressure ulcer prevention is the responsibility of all members of the health care team, the disproportionate burden of looking after those at risk falls into the hands of nurses. Therefore, education of nursing staff is essential to ensure a good understanding of the factors relating to pressure ulcer prevention. Education should include pathophysiology related to pressure ulcer development, recognition of the importance of effective skin care, the most up-to-date preventative strategies and finally, effective measures in management of pressure ulcers. Hospital management should be fully aware of the personal and financial costs associated with this important nosocomial condition and provide a streamlined process for the acquisition of pressure-relieving devices and treatment options. The incidence of pressure ulcers should be reported in an incident monitoring system, which would ensure that health administrators are fully conversant with the prevalence of this potentially preventable complication and factor in resources for prevention and management into budgetary allocations. Importantly, more research into risk stratification, clinical decision support tools and prevention strategies for patients in high-risk environments like intensive care must be undertaken. Without doubt, a new direction is ‘sorely’ needed.