Internationally, the prevalence of surgery-associated pressure ulcer is about 12 %. To optimize the perioperative skin screening and the communication between ward and operating room, the project followed the principles of participative action research. In the first phase, the current situation was evaluated and a systematic literature search was conducted. Based on these results, an evidence-based procedure of skin screening and a feedback loop for the procedure of skin damage were developed in the second phase. The processes were presented as an algorithm in a pocket guide. In the third phase, the instruments were tested and measures to improve them were initiated.