The impact of a risk assessment tool on hospital pressure injury prevalence and prevention: a quantitative pre-post evaluation

Background: Pressure injuries are preventable adverse events, and their prevalence is established as a quality indicator in healthcare. They are a notable healthcare problem worldwide, as they have a significant impact on the quality of life of affected individuals and are associated with high costs...

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Main Authors: Ragnar Seton, Elisabeth Wetzer, Lisa Hultin
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:International Journal of Nursing Studies Advances
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666142X25000517
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author Ragnar Seton
Elisabeth Wetzer
Lisa Hultin
author_facet Ragnar Seton
Elisabeth Wetzer
Lisa Hultin
author_sort Ragnar Seton
collection DOAJ
description Background: Pressure injuries are preventable adverse events, and their prevalence is established as a quality indicator in healthcare. They are a notable healthcare problem worldwide, as they have a significant impact on the quality of life of affected individuals and are associated with high costs for healthcare systems. The use of an evidence-based risk assessment instrument is, therefore, crucial to enable efficient, effective, and reliable assessments. Objective: The evidence-based pressure injury risk assessment instrument PURPOSE T was widely introduced at a university hospital in 2021, replacing another commonly used assessment tool, the Modified Norton Scale. In this study, we quantified the prevalence of pressure injuries before and after the introduction of PURPOSE T to measure the tool’s impact. Settings: At a university hospital in Sweden with about 900 beds. Methods: We adopted a cross-sectional research design and analysed records from point prevalence measurements carried out between September 2018 and 2023. The number of patients included in each point prevalence measurement varied between 474 and 633. Prevalence of all pressure injuries and prescribed prevention interventions over a 5-year period was calculated, compared, and analysed. Results: We observed notable increases in the use of preventive interventions, particularly pressure-reducing chair cushions (+28.6 %) and position adjustments in chairs (+24.2 %). Additionally, we found an average increase of +23.0 % in the prevalence of category I pressure injuries after the introduction of PURPOSE T while observing a decrease in most severe pressure injury categories:35.5 % in category III and -35.3 % in category IV. Conclusions: We found that the introduction of PURPOSE T contributed to the increased use of preventive interventions. This, in turn, was associated with a decrease or modification in the prevalence of pressure injuries, suggesting a positive impact on pressure injury within this facility.
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spelling doaj-art-b1ea4e8b71c14fa88ae7996c817faa8e2025-08-20T02:31:12ZengElsevierInternational Journal of Nursing Studies Advances2666-142X2025-06-01810034210.1016/j.ijnsa.2025.100342The impact of a risk assessment tool on hospital pressure injury prevalence and prevention: a quantitative pre-post evaluationRagnar Seton0Elisabeth Wetzer1Lisa Hultin2Department of Physics and Technology, UiT The Arctic University of Norway, Tromsø, NorwayDepartment of Physics and Technology, UiT The Arctic University of Norway, Tromsø, NorwayDepartment of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Uppsala university hospital, Sweden; Corresponding author at: Uppsala University, IFV, Husargatan 3, Box 564, 751 23 Uppsala, Sweden.Background: Pressure injuries are preventable adverse events, and their prevalence is established as a quality indicator in healthcare. They are a notable healthcare problem worldwide, as they have a significant impact on the quality of life of affected individuals and are associated with high costs for healthcare systems. The use of an evidence-based risk assessment instrument is, therefore, crucial to enable efficient, effective, and reliable assessments. Objective: The evidence-based pressure injury risk assessment instrument PURPOSE T was widely introduced at a university hospital in 2021, replacing another commonly used assessment tool, the Modified Norton Scale. In this study, we quantified the prevalence of pressure injuries before and after the introduction of PURPOSE T to measure the tool’s impact. Settings: At a university hospital in Sweden with about 900 beds. Methods: We adopted a cross-sectional research design and analysed records from point prevalence measurements carried out between September 2018 and 2023. The number of patients included in each point prevalence measurement varied between 474 and 633. Prevalence of all pressure injuries and prescribed prevention interventions over a 5-year period was calculated, compared, and analysed. Results: We observed notable increases in the use of preventive interventions, particularly pressure-reducing chair cushions (+28.6 %) and position adjustments in chairs (+24.2 %). Additionally, we found an average increase of +23.0 % in the prevalence of category I pressure injuries after the introduction of PURPOSE T while observing a decrease in most severe pressure injury categories:35.5 % in category III and -35.3 % in category IV. Conclusions: We found that the introduction of PURPOSE T contributed to the increased use of preventive interventions. This, in turn, was associated with a decrease or modification in the prevalence of pressure injuries, suggesting a positive impact on pressure injury within this facility.http://www.sciencedirect.com/science/article/pii/S2666142X25000517Evaluation studyPressure injury/pressure ulcerNursingPreventionRisk assessmentQuantitative
spellingShingle Ragnar Seton
Elisabeth Wetzer
Lisa Hultin
The impact of a risk assessment tool on hospital pressure injury prevalence and prevention: a quantitative pre-post evaluation
International Journal of Nursing Studies Advances
Evaluation study
Pressure injury/pressure ulcer
Nursing
Prevention
Risk assessment
Quantitative
title The impact of a risk assessment tool on hospital pressure injury prevalence and prevention: a quantitative pre-post evaluation
title_full The impact of a risk assessment tool on hospital pressure injury prevalence and prevention: a quantitative pre-post evaluation
title_fullStr The impact of a risk assessment tool on hospital pressure injury prevalence and prevention: a quantitative pre-post evaluation
title_full_unstemmed The impact of a risk assessment tool on hospital pressure injury prevalence and prevention: a quantitative pre-post evaluation
title_short The impact of a risk assessment tool on hospital pressure injury prevalence and prevention: a quantitative pre-post evaluation
title_sort impact of a risk assessment tool on hospital pressure injury prevalence and prevention a quantitative pre post evaluation
topic Evaluation study
Pressure injury/pressure ulcer
Nursing
Prevention
Risk assessment
Quantitative
url http://www.sciencedirect.com/science/article/pii/S2666142X25000517
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