Hospital-acquired pressure injuries (HAPIs) affect an estimated 2.5 million patients annually in the United States. These injuries, like bedsores and pressure sores around medical devices, increase the length and cost of hospitalization and raise the risk of serious complications that delay recovery.
In fact, patients with HAPIs experience a 5% higher mortality rate compared to those without.
HAPIs compromise patient health, strain staff time, and often require extended care plans that push back discharge timelines. But despite national efforts to prevent pressure injuries, the rate of HAPIs has stayed stubbornly high at around 3.5% nationwide.
Healthcare facilities that have adopted standardized prevention and treatment strategies, however, report markedly lower HAPI rates.
For hospitals and clinics focused on reducing bed sores, ulcers, and other pressure injuries, these proactive and reactive care tips can help improve patient safety and accelerate HAPI recovery.
Phase One: Reducing HAPI rates at your facility
One of the most effective methods for reducing pressure sores in hospitals is patient mobilization. Regular repositioning lessens the pressure on sensitive tissue and helps to preserve tissue integrity. But in reality, mobilization isn’t always practical or possible—especially for patients who are sedated, critically ill, or immobilized. It’s also time-intensive and requires an extra level of care coordination from the nursing staff. In these cases, movement alone may not be enough to prevent HAPI tissue damage, and other rate reduction methods must be used.
Modifications to medical devices that trigger HAPIs are another common—and commonly overlooked—way to reduce pressure injuries. Choosing alternative devices that minimize pressure on the sensitive area, like choosing an “under the nose” BiPAP mask rather than a full-face option, can reduce the likelihood of device-related pressure ulcers.
Whether the pressure sores come from lack of movement or a medical device, early and frequent skin assessments help to reveal vulnerable areas and early-stage pressure wounds before they progress to full-thickness injuries. All patients should receive a comprehensive skin check within 24 hours of hospital admission, plus regular evaluations throughout their stay—especially if movement is limited. Any sign of new redness or skin changes should be rapidly addressed to support a fast recovery with minimal complications.
Clinical documentation and nursing staff education also play a major role in reducing a hospital’s pressure-injury rates. Nurses and healthcare support staff should be trained to recognize the early signs of bed sores and HAPIs in addition to the risks that predispose patients to HAPI development.
Multiple hospital-led projects have shown that improving education for new and seasoned nurses paired with a standardized assessment process can quickly and significantly reduce HAPI rates. While the specific methods varied by hospital, most are based around a few key strategies: improving communication at shift handoffs, reducing risk factors with protective devices and patient mobilization, and accelerating the stage-appropriate treatment of HAPIs that do develop.
Phase Two: Stage-Directed Care when Pressure Injuries Do Occur
Even with strategic prevention strategies, some hospital-acquired bedsores and pressure injuries are unavoidable. In these cases, recovery depends on quickly adapting your treatment plan to the injury stage and severity.
Stage I and II HAPIs are less severe and typically limited to superficial tissue damage. Their depth and surface size are small, so they’re often reversible if addressed early, before infection sets in. Interventions aimed at offloading the pressure, protecting skin integrity, and preventing progression while keeping the wound area free from contamination all help these minor wounds heal naturally without long-term complications.
Stage III or IV HAPIs, larger ulcers or sores, are more severe. These wounds can deepen to the muscle, tendon, or bone. The consequences are serious—ranging from localized infection and abscess formation to systemic sepsis, surgical debridement, and even limb amputation. For these bedsores and pressure injuries, infection control plays a major role in full recovery.
Across all stages of HAPI development, these tips can keep them clean and encourage complete healing:
- Reposition frequently to offload pressure from the affected area and prevent further tissue breakdown.
- Use pressure-reducing surfaces like specialized mattresses, overlays, or cushions that distribute weight more evenly.
- Remove necrotic tissue through mechanical, surgical, or chemical debridement to reduce bacterial load and stimulate granulation. This also allows for more accurate pressure injury staging and recovery monitoring.
- Use a topical antimicrobial to consistently reduce the bioburden in the wound bed. Systemic antibiotics have been shown to be ineffective at lowering the bacterial bioburden in pressure wounds.
- Keep the pressure injury or bedsore clean by rinsing with an effective wound cleansing solution such as Dakin’s, covering the wound appropriately, and maintaining a balanced pH and moisture environment to support tissue repair.
While these HAPI reduction and treatment strategies do require additional attention and effort from nursing staff, plus the added costs of specialized bedding, support surfaces, alternative low-risk medical devices, and treatment solutions, the overall benefits from implementing a HAPI reduction program are significant.
The National Pressure Injury Prevention Panel estimates that severe HAPIs can cost as much as $150,000 per injury. Reducing HAPI events at your facility can add up to hundreds of thousands of dollars in savings—and improve overall patient outcomes.
The clinical value of Dakin’s Solution for hospital-acquired pressure injury care
The antimicrobial action of Dakin’s Solution helps cleanse exposed wound beds and inhibit biofilm formation—a key barrier to healing in chronic and deep-tissue wounds.
Unlike many antiseptics, Dakin’s Wound Cleanser is non-cytotoxic to granulation tissue and works without impairing the body’s natural repair process. Plus it’s non-sensitizing, non-irritating, and contains no antibiotic, alcohol, or steroids, so healing is simple and side effect-free.
Dakin’s Solution is available in multiple concentrations, making it adaptable to the severity of the pressure injury—from early-stage skin damage to complex Stage IV wounds with extensive tissue loss.
Dakin’s offers the ideal balance of tissue preservation, microbial control, and healing efficiency. As part of a standardized treatment plan, it’s a reliable, evidence-backed tool for reducing bedsore complications and improving outcomes in patients with HAPIs.
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