Prevention and Nursing Management of Hospital-Acquired Pressure Injuries Among Bedridden Patients: A Patient-Centered Review of Risk Assessment, Repositioning Practices, Skin Care, and Quality Nursing Interventions

Abstract

Background: Hospital-acquired Pressure Injuries (HAPIs) are localised injuries to skin and/or underlying tissue caused by sustained pressure or pressure combined with shear. Bedridden patients are particularly vulnerable because they may be unable to reposition independently and often have additional risks such as impaired perfusion, reduced sensation, moisture exposure, malnutrition, or critical illness. These injuries can cause pain, infection, delayed recovery, longer hospital stays, and avoidable resource use. Aim: This review summarizes practical, evidence-informed nursing strategies for preventing and managing HAPIs in bedridden patients, with emphasis on individual risk assessment, skin and tissue inspection, repositioning, pressure-redistributing surfaces, moisture control, nutrition, medical-device checks, and quality improvement. Review Approach: This is a focused narrative review informed by international guidance and selected systematic reviews, clinical trials, epidemiological studies, and quality-improvement resources. It is not a new systematic review, and no pooled estimate or formal risk-of-bias assessment was undertaken. Recommendations should be adapted to the patient, clinical setting, resources, and local policy. Main Discussion: A risk score can support but should not replace clinical judgement. Prevention is strongest when assessment leads to a documented care plan that combines timely repositioning and mobilization, heel off-loading, appropriate support surfaces, gentle skin cleansing, moisture management, nutrition screening, device surveillance, and patient and family participation. Existing injuries require accurate classification, wound assessment, pressure relief, pain control, and escalation for infection or deterioration. Reliable implementation depends on education, staffing, documentation, audit, and feedback. Conclusion: HAPI prevention is a continuous, patient-centred nursing responsibility rather than a single intervention. Consistent delivery of a tailored prevention bundle, together with early recognition and measurement of outcomes, can improve safety and reduce preventable harm.