Pressure injuries remain preventable and impose a financial burden despite decades of attention to prevention. For wound care professionals, educating themselves on the epidemiology, high-risk populations, and evolving guidelines surrounding pressure injury prevention is essential to improving patient care.

Why This Matters

• Pressure injuries remain common: more than 2.5 million people in the United States develop pressure injuries annually, while global data have estimated pressure injury prevalence among hospitalized adults at approximately 12.8%.^1,2 
• The burden is concentrated among vulnerable populations, including critically ill patients, older adults, people with impaired mobility or perfusion, and patients exposed to medical devices; device-related pressure injury prevalence in adult ICUs has been estimated at 19.0%.^3,4
• Prevention is both a patient-outcomes and workforce competency issue. A meta-analysis found that nurses achieved a pooled pressure injury prevention knowledge score of only 51.5%, underscoring why continuing professional education remains relevant.⁵

Pressure Injuries Remain a Major Patient Care Burden

Pressure injuries are localized injuries to skin and/or underlying tissue associated with pressure or pressure combined with shear. The Agency for Healthcare Research and Quality (AHRQ) reports that more than 2.5 million people in the United States develop pressure injuries each year.¹ Pressure injuries are associated with pain, serious infection risk, increased healthcare utilization, longer hospitalization, morbidity, and mortality.¹

The problem extends well beyond the United States. A large systematic review and meta-analysis encompassing more than 2.5 million hospitalized adults across the globe estimated a pooled pressure injury prevalence of 12.8% and a hospital-acquired pressure injury prevalence of 8.4%.² 

Despite the prevalence of pressure injuries and decades of facility-based prevention efforts the Wound Healing Society's updated 2023 guideline notes that pressure injury incidence has not meaningfully declined.³

The Human and Financial Costs of Pressure Injuries

People who are older, critically ill, or have spinal cord injury or disease are among the major populations at risk for pressure injuries.³ A 2025 systematic review found that independent pressure injury risk factors in critically ill patients included older age, limited mobility or activity, impaired perfusion, vasopressor use, and longer ICU length of stay.⁶

Medical devices add another risk. A 2023 meta-analysis involving 10,084 adult ICU patients across 11 countries estimated pooled medical device–related pressure injury incidence at 14.7% and pooled prevalence at 19%.⁴ Patients receiving mechanical ventilation had substantially greater odds of device-related pressure injury than patients who were not mechanically ventilated (odds ratio, 9.67).⁴

The issue also extends to pediatric populations. A 2023 systematic review and meta-analysis of 25,742 pediatric patients estimated medical device–related pressure injury prevalence at 7.8%, with external monitoring and respiratory devices among the most frequently implicated device categories.⁷

The consequences of pressure injuries extend beyond visible tissue damage. A 2022 meta-synthesis examining patient and caregiver experiences identified loss of autonomy and independence, psychological effects, social isolation, functional challenges, and physical consequences among recurring themes associated with living with a pressure injury.⁸

The financial implications are similarly substantial. The 2023 Wound Healing Society guideline cites an estimated annual U.S. health system cost of approximately $26.8 billion for hospital-acquired pressure injuries, with more than half of that burden attributed to Stage 3 and Stage 4 injuries.³ Regulatory measures have also arisen that place a negative financial or reimbursement impact on specified hospital-acquired conditions.⁹

Together, these clinical, economic, quality, and reimbursement dimensions make pressure injury prevention consequential at the bedside and at the organizational level.

Studies Point Toward Persistent Knowledge Gaps in Pressure Injury Prevention

Preventing pressure injuries depends on healthcare providers keeping pace with an evolving evidence base, increasingly complex patients, and changing clinical environments.

A 2022 systematic review and meta-analysis using the Pressure Ulcer Knowledge Assessment Tool found a pooled prevention-knowledge score of only 51.5% among nurses and 48.9% among nursing students. The lowest scores involved preventive measures related to pressure and shear.⁵

A 2026 systematic review of 29 studies reported that nurses' prevention knowledge was frequently inadequate and preventive practices were often suboptimal, while barriers included staffing shortages, workload, limited resources, and insufficient institutional support.¹⁰

Why Pressure Injury Prevention Matters Now

Pressure injury prevention remains an important topic for wound care education precisely because it is familiar yet unresolved. Millions of patients remain affected, high-risk populations continue to expand, medical device–related injuries present additional challenges, and the consequences extend from quality of life to institutional performance and healthcare expenditures.

The evidence base is also continuing to evolve. The National Pressure Injury Advisory Panel International Guideline's latest prevention content reflects ongoing multidisciplinary efforts to synthesize contemporary evidence and recommendations for pressure injury prevention.¹¹

The epidemiologic burden, complexity of contemporary patient populations, and measurable workforce knowledge gaps make pressure injury prevention an area in which staying current matters to clinicians, organizations, and at-risk patients.

References
1.    Agency for Healthcare Research and Quality. Topic: Pressure ulcers. Available at https://www.ahrq.gov/topics/pressure-ulcers.html. Accessed August 13, 2026.
2.    Li Z, Lin F, Thalib L, Chaboyer W. Global prevalence and incidence of pressure injuries in hospitalised adult patients: a systematic review and meta-analysis. Int J Nurs Stud. 2020;105:103546. doi:10.1016/j.ijnurstu.2020.103546.
3.    Gould LJ, Alderden J, Aslam R, et al. WHS guidelines for the treatment of pressure ulcers—2023 update. Wound Repair Regen. 2024;32(1):6-33. doi:10.1111/wrr.13130.
4.    Jia YJ, Hu FH, Zhang WQ, et al. Incidence, prevalence and risk factors of device-related pressure injuries in adult intensive care unit: a meta-analysis of 10,084 patients from 11 countries. Wound Repair Regen. 2023;31(5):652-663. doi:10.1111/wrr.13112.
5.    Wu J, Wang B, Zhu L, Jia X. Nurses' knowledge on pressure ulcer prevention: an updated systematic review and meta-analysis based on the Pressure Ulcer Knowledge Assessment Tool. Front Public Health. 2022;10:964680. doi:10.3389/fpubh.2022.964680.
6.    Alderden J, Brooks KR, Kennerly SM, Yap TL, Dworak E, Cox J. Risk factors for pressure injuries in critical care patients: an updated systematic review. Int J Nurs Stud. 2025 Sep;169:105127. doi: 10.1016/j.ijnurstu.2025.105127. Epub 2025 May 28. PMID: 40516188.
7.    Şimşek E, Demir AS, Semerci R, Karadağ A. The incidence and prevalence of medical device-related pressure injuries in pediatric patients: Systematic review and meta-analysis. J Pediatr Nurs. 2023 Sep-Oct;72:e130-e138. doi: 10.1016/j.pedn.2023.06.019. Epub 2023 Jun 19. PMID: 37344345.
8.    Burston A, Miles SJ, Fulbrook P. Patient and carer experience of living with a pressure injury: A meta-synthesis of qualitative studies. J Clin Nurs. 2023 Jul;32(13-14):3233-3247. doi: 10.1111/jocn.16431. Epub 2022 Jun 29. PMID: 35768933.
9.    Centers for Medicare & Medicaid Services. FY 2026 Hospital Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System Final Rule—CMS-1833-F. Available at https://www.cms.gov/newsroom/fact-sheets/fy-2026-hospital-inpatient-pro…. Published August 2025. Accessed Aug. 13, 2026. 
10.    Asiri MY, Baker OG, Alanazi HI, et al. Nurses' knowledge, attitudes, and practices in pressure injury prevention: a systematic review and meta-analysis. Healthcare (Basel). 2025 May 22;13(11):1220. doi: 10.3390/healthcare13111220. PMID: 40508833; PMCID: PMC12154237.
11.    National Pressure Injury Advisory Panel, European Pressure Ulcer Advisory Panel, Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline. Available at https://npiap.com/page/InternationalGuidelines. Accessed August 13, 2026.