Utilization of Pressure Injury Prevention Interventions in Acute Care Hospitals

Pressure injuries (PIs) remain a significant clinical concern, negatively impacting quality of life for patients and increasing health care costs. Abundant research highlights the critical importance of preventing PIs through nursing interventions. Despite decades of research and widespread use of evidence-based preventive strategies, PIs that develop during an inpatient stay, known as hospital-acquired pressure injuries (HAPIs), continue to represent a major challenge for clinical practice.

The aim of this study was to examine the relationship between nurses' adherence to PI prevention practices and HAPI development.

PI data submitted to the 2022 National Database of Nursing Quality Indicators (NDNQI) from 1,379 acute care facilities were used to examine the prevalence of PIs and the use of preventive interventions in 355,031 high-risk patients. Utilization of four preventive interventions was determined for three groups of patients: those without PIs, those with superficial PIs (stages 1 and 2), and those with severe PIs (stages 3 and 4, unstageable, deep tissue pressure injury). Chi-square tests were calculated to identify significant differences in the utilization of preventive interventions among the three groups.

A total of 13,500 high-risk patients were found to have PIs for a HAPI prevalence rate of 3.8%. Among the four prevention interventions, pressure redistribution and moisture management were performed the most consistently-from 91.9% to 95.4%-across all three PI groups. Nutritional support and routine repositioning were performed the least frequently-from 78.6% to 90.4%-across all three PI groups. Overall, the highest utilization of preventive interventions was reported in patients with severe PIs and the lowest in patients with superficial PIs.

These findings demonstrate consistent adherence to PI preventive practices for at-risk patients. Additionally, findings suggest that more consistent nutritional support and routine repositioning are areas for improvement in preventive practices.