This article describes three strategies a cardiovascular-thoracic intensive care unit implemented to decrease the rate of hospital-acquired pressure ulcers in patients on extracorporeal membranous oxygenation support. These strategies include increased staff awareness of physiologic factors placing a critically ill patient on extracorporeal support at increased risk for development of pressure ulcers, development of a turning guideline and a skin care bundle, and use of coaching by a clinical nurse specialist to promote pressure ulcer prevention.