Abstract

Pressure injuries (PIs) are serious hospital‑acquired soft‑tissue adverse events induced by sustained pressure, shear stress and frictional force. Across global acute‑care medical institutions, hospital‑acquired pressure injuries continue to impose heavy clinical and socioeconomic burdens, particularly within intensive‑care, geriatric, oncological, cardiac‑surgical and long‑term rehabilitation hospital wards (Coleman et al., 2024). Patients suffering from newly‑developed pressure injuries face elevated risks of local soft‑tissue necrosis, secondary bacterial infection, biofilm formation, sepsis, prolonged hospital stay, functional decline, palliative‑care burden and all‑cause mortality (Moore et al., 2023; Gillespie et al., 2022). Sub‑clinical deep‑tissue damage without visible epidermal breakage is easily missed during routine ward assessment, contributing to silent progression toward full‑thickness pressure injury (Black et al., 2025). The updated NPIAP‑EPUAP‑PPPIA 2025 international clinical guideline revises core definitions, risk‑assessment workflows, differential‑diagnosis algorithms for deep‑tissue pressure injury, device‑related injury classification and evidence‑based preventive nursing bundle components, providing updated consensus for global clinical nursing practice (Black et al., 2025). Emerging research has explored circulating biological markers, artificial‑intelligence‑assisted skin image recognition, and subgroup‑tailored prevention protocols for cardiac‑surgical, prone‑position ventilated and frail older‑adult inpatients (Pereira et al., 2024; Li et al., 2023). This narrative review comprehensively elaborates non‑modifiable and modifiable risk dimensions of pressure injuries for adult hospitalized patients, summarizes multi‑dimensional evidence‑based preventive nursing interventions, discusses implementation obstacles existing in real‑world clinical nursing settings, reviews emerging innovative preventive approaches, and puts forward targeted improvement suggestions. This work intends to supply high‑quality theoretical reference for front‑line clinical nurses to implement standardized pressure‑injury prevention workflows and lower the incidence of hospital‑acquired pressure injuries.

Keywords: hospitalized patients; pressure injury; risk factors; preventive nursing; evidence‑based nursing; care bundle; hospital‑acquired pressure injury

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