Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2026 Mar 3.
doi: 10.1097/WON.0000000000001274. Online ahead of print.

Large-Scale Coordinated Prevention of Pressure Injuries in Public Hospitals: Review of a Statewide Hospital-Acquired Pressure Injury Prevention Program Over 15 Years in Australia

Affiliations

Large-Scale Coordinated Prevention of Pressure Injuries in Public Hospitals: Review of a Statewide Hospital-Acquired Pressure Injury Prevention Program Over 15 Years in Australia

Yohani Dalugoda et al. J Wound Ostomy Continence Nurs. .

Abstract

Purpose: The purpose of this retrospective study was to evaluate the effect of an organization-level, hospital-acquired pressure injury (HAPI) prevention program over a 15-year period. A secondary aim was to summarize the program priority areas, and the resources used to inform and support its delivery.

Design: Retrospective statewide audit.

Subjects and setting: Sixteen hospital and health services in Queensland, Australia, provided HAPI-related indicator data between 2013 and 2018, involving up to 4245 hospital inpatients each year.

Methods: A retrospective evaluation was undertaken using statewide audit data from up to 121 hospitals collected annually between 2003 and 2018. Outcomes of interest were HAPI prevalence and related indicators (n = 6). Priority focus areas of the program and supporting resources were extracted from annual reports, strategic plans, meeting minutes, and an internal publishing database.

Results: Following commencement of the program in 2006, HAPI prevalence decreased from 14% to 3% in 2018, with corresponding improvements in all 6 related indicators. Program focus areas and supporting resources were multifaceted and evidence based, targeting organizational policy, guidelines, equipment use, procurement, clinical tools, and education. A range of data sources informed the annual program focus including audit, evaluation, and pressure injury clinical incident data.

Conclusion: The formation of a statewide HAPI prevention program coincided with a sizeable reduction in HAPI prevalence. This evaluation demonstrates that large-scale quality improvement programs to reduce HAPIs can be effective and sustainable.

Keywords: Clinical audit; Pressure injury; Pressure ulcer; Prevention; Quality improvement.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

References

    1. Padula WV, Pronovost PJ. Addressing the multisectoral impact of pressure injuries in the USA, UK and abroad. BMJ Qual Saf. 2018;27(3):171-173. doi:10.1136/bmjqs-2017-007021 - DOI
    1. Liu S, Rawson H, Islam RM, Team V. Impact of pressure injuries on health-related quality of life: a systematic review. Wound Repair Regen. 2025;33(1):e13236. doi:10.1111/wrr.13236 - DOI
    1. 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 - DOI
    1. Rodgers K, Sim J, Clifton R. Systematic review of pressure injury prevalence in Australian and New Zealand hospitals. Collegian. 2021;28(3):310-323. doi:10.1016/j.colegn.2020.08.012 - DOI
    1. Walker RM, Gillespie BM, McInnes E, et al. Prevention and treatment of pressure injuries: a meta-synthesis of Cochrane Reviews. J Tissue Viability. 2020;29(4):227-243. doi:10.1016/j.jtv.2020.05.004 - DOI

LinkOut - more resources