for the main comparison.

Evidence‐based standardised nursing procedure to improve care of patients at risk of developing hospital‐acquired pressure ulcers (HAPUs)
Patient or population: nurses, and patients admitted with a Braden score less than or equal to 18 (i.e. at risk of developing HAPUs) Settings: one hospital Intervention: evidence‐based standardised nursing procedure Comparison: N/A
Outcomes	Change in level effect (mean rate per quarter) (95% CI)*	No of participants (studies)	Quality of the evidence (GRADE)	Comments
HAPU rate	At 3 months: 0.7% (95% CI ‐1.7 to 3.3), P = 0.465)	One hospital (1)	⊕⊝⊝⊝ very low quality*	Before the intervention there was a statistically significant (P = 0.046) decrease in mean HAPU rate by 1.1% per quarter Given the small percentages post intervention it was not possible to extrapolate effects beyond 3 months
* We downgraded the evidence on the basis of imprecision and the downward trend in HAPU rate found already in the pre‐intervention period. GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.