How Healthcare Organizations Can Reduce Harm, Support Clinical Teams, and Improve Patient Outcomes
By Jason Bobay, President and CEO, RF Health
LinkedIn: Jason Bobay
LinkedIn: RF Health
Hospital-acquired pressure injuries (HAPIs) are one of the most common and costly hospital-acquired conditions in the United States, despite being largely preventable. Approximately 1 in 10 hospitalized patients develops a pressure injury during their length of stay (LOS), with more than 2.5 million people affected annually.
The cost of HAPIs is staggering. The U.S. healthcare system spends an estimated $12 billion each year managing these injuries, and when chronic cases are included, the number climbs to more than $22 billion. For individual patients, treatment can cost anywhere from $20,900 to $157,700 per pressure injury. Beyond the financial burden, HAPIs are linked to a 57% longer LOS and a 22% higher rate of 30-day readmissions, underscoring their profound impact on both patients and healthcare systems.
The Impact on Healthcare Teams and Patients
The sacrum and heels are the two most common sites to develop pressure injuries. Both lead to increased patient suffering, longer recovery times, a higher risk of infection, increased mortality rates, and decreased quality of life.
HAPIs also require additional attention, time, and care coordination from healthcare staff. For example, in a 500-bed hospital, more than 150 nursing hours a day may be devoted to managing and preventing HAPIs. Additionally, lifting, boosting, transferring, and repositioning patients is the leading cause of work-related musculoskeletal disorders in healthcare. The cumulative weight a nurse may have to lift during an 8-hour shift is equivalent to 1.8 tons (or 9 tons per week).
Consequences of hospital-acquired pressure injuries also extend beyond the bedside. They come with financial penalties, reputational risk, and greater resource utilization for healthcare providers. As a result, healthcare organizations must rethink how pressure injury prevention is integrated into care workflows to improve patient outcomes, operational efficiency, and work-life quality.
Rising Regulatory Pressures
The Centers for Medicare & Medicaid Services (CMS) recognizes the occurrence of hospital-acquired pressure injuries as a growing concern and an indicator of the quality of care in healthcare settings. Hospitals are currently required to report Stage 3 and 4 pressure injuries for quality and reimbursement purposes; however, this is due to change soon.
CMS recently introduced an electronic Clinical Quality Measure (eCQM) called “Hospital Harm – Pressure Injury” for the 2025 Inpatient Quality Reporting (IQR) program. This will expand reporting requirements to include Stage 2 pressure injuries. While this measure is voluntary in 2025, it will become mandatory in 2028 and is expected to impact reimbursement rates.
This signals a broader regulatory shift toward increased accountability, transparency, earlier detection, preventative measures, and more substantial incentives for pressure injury prevention. Hospitals that wait to adapt to these new requirements risk financial penalties and lower performance scores in the future.
Pressure Injury Prevention and Management Strategies
Consider this: The cost of preventing hospital-acquired pressure injury is significantly lower than the cost of treatment.
Patients are at a higher risk of developing a pressure injury if they have:
- Limited mobility
- A medical condition that prevents them from changing positions or moving
- A Braden Score of 18 or less
However, most pressure injuries are preventable with appropriate and timely interventions. The National Pressure Injury Advisory Panel (NPIAP) outlines key strategies for prevention, such as:
Core Prevention Practices
- Repositioning a patient every two hours is the cornerstone of pressure relief, especially for those at-risk
- Use a 30-degree turn to effectively offload the sacrum and protect vulnerable areas such as bony prominences
- Use heel offloading devices that elevate (float) and offload the heel completely
Tools and Support Devices
- Follow the NPIAP Standardized Pressure Injury Prevention Protocol (S-PIPP) checklist for daily assessment and care planning
- Use offloading tools such as specialized support surfaces to redistribute pressure
- Use positioning aids that reduce shear and friction, which contribute to tissue breakdown
- For immobile patients, utilize high-specification reactive foam surfaces to improve pressure redistribution
Mobility and Engagement
- When possible, implement early mobilization activities to encourage movement and reduce immobility-related pressure
- Engage patients and their caregivers in education around repositioning and the importance of early and frequent movement
Healthcare organizations can make significant progress in reducing pressure injury rates by aligning care practices with these proven strategies.
The Importance of Immersion and Envelopment
Unfortunately, many commonly used support surfaces by hospitals do not provide effective immersion and envelopment, two essential characteristics for optimal pressure redistribution, which limits their effectiveness in at-risk patients. Clinical literature, including guidance from the National Pressure Injury Advisory Panel (NPIAP), emphasizes the importance of load distribution during immersion and envelopment to minimize pressure injury risk.
Immersion is the capability of a support surface to distribute body weight, enabling a user to “sink in,” and envelopment is the ability of the surface to conform to the body’s shape as it sinks in. Together, these properties reduce pressure on areas vulnerable to HAPIs, such as the sacrum and heels. Therefore, hospitals should prioritize investment in advanced surfaces designed to optimize immersion and envelopment as a critical part of a comprehensive pressure injury prevention strategy.
Conclusion
Adopting new and innovative pressure injury prevention techniques not only enhances patient care but also transforms the operational effectiveness of healthcare organizations. By proactively implementing advanced support surfaces and tailored prevention strategies, healthcare facilities can substantially reduce the incidence of hospital-acquired pressure injuries.
This approach lowers costs, minimizes regulatory penalties, and enhances the quality of life for patients. Furthermore, it lessens the burden of clinical teams, ultimately enabling them to focus more time on providing quality care.