Abstract: Objective: To explore the application effects of total process management in prevention of hospital-acquired pressure ulcers (HAPU) in elderly patients. Methods: The total process management was performed by setting up the process managing group, formulating the management standards of pressure ulcer by standardizing, optimizing and reengineering process, and grasping some key points and problems in the operating process. The prevention effects of HAPU in elderly patients were compared before and after the implementation of total process management. Results: After one year's clinical practice, the incidence rate of HAPU in elderly patients was reduced form 0.28% to 0.16%; the incidence rate of inevitable HAPU was reduced from 8.4% to 6.2%, the differences were significant (P<0.01). Conclusion: The implement of total process management make a procedural, standard and scientific management for pressure ulcer, decrease the incidence rate of HAPU in elderly patients, and improve the nursing quality of pressure ulcers prevention in elderly patients.