Background: Pressure ulcers are common and one of the most serious disorders that may occur to patients during hospitalization. Previous studies have shown education and knowledge affect the implementation of interventions which are one of the main responsibilities of nursing staff and the administrative authority for improving the quality of nursing care and decreasing patients' morbidity. Aim of the study: Assessment of nurses' knowledge and practice regarding prevention and early detection of pressure ulcer, developing protocol for prevention and early detection of pressure ulcer for nurses in Damanhur National Medical Institute. Research questions: What are the nurses' knowledge regarding the prevention and early detection of pressure ulcers in Damanhur National Medical Institute? What are the nurses' practices regarding the prevention and early detection of pressure ulcers in Damanhur National Medical Institute? Do nurses need protocol for prevention and early detection of pressure ulcers in Damanhur National Medical Institute? Research design: A descriptive cross-sectional research design was used. Setting: Study was conducted at Damanhur National Medical Institute El Behaira governorate from the orthopedic, neurology unit and intensive care unit. Subjects: Finite sample, in total 111 nurses out of 140 nurses who work in orthopedic, neurology and intensive care units. Tool: One tool was used for data collection and consisted of four parts. The self administered questionnaire was designed for data collection of all the four parts. Results: The mean score of nurses' practice on screening for pressure ulcer risk was less than half comparing to mean of nurses' assessment of unit care plan for prevention of pressure ulcer which got a maximum score. The mean general nurses' knowledge of pressure ulcer prevention was more than one third. Conclusion: the present study finding concluded that: there were significant relations between nurses' knowledge, practice, and unit care plan. Recommendation: Included physicians, patients, and family in the nursing care plan.