Prevention Starts with Biology: Rethinking Pressure Injury Prevention

Despite decades of evolving prevention strategies, pressure injury outcomes are not improving. In fact, they are worsening. Our latest webinar, “Prevention Starts with Biology,” explores why this is happening and what healthcare leaders, clinicians, and financial stakeholders can do differently. 

At the core of the issue is a reliance on subjective assessment methods. Traditional prevention approaches such as risk scoring tools and visual skin assessments are widely used but inherently limited. They depend on what clinicians can see and interpret, yet pressure injuries begin beneath the skin, often days before any visible signs appear. 

This creates a critical gap. By the time damage is detectable through visual inspection, tissue injury may already be well underway. 

In the webinar, Dr. Rhonda Sullivan outlines a fundamental shift in thinking: pressure injuries are a biological process. When pressure and shear disrupt blood flow, tissue damage begins at the cellular level, triggering inflammation and fluid accumulation known as sub-epidermal moisture (SEM). This process can develop 3 to 10 days before visible injury occurs. 

The implication is clear: if prevention strategies rely solely on surface-level assessment, they are inherently reactive rather than proactive. 

This is where biology-driven assessment changes the paradigm. By measuring SEM, clinicians gain access to an objective, early indicator of tissue stress. This allows for: 

• Earlier detection of developing pressure injuries 

• More precise and targeted interventions 

• Improved consistency in care delivery 

• Enhanced documentation accuracy 

For nurses and wound care teams, this means moving from generalized prevention bundles to patient- and site-specific decision-making. For hospital leaders and CFOs, it introduces an opportunity to reduce unnecessary interventions, optimize workforce efficiency, and lower the total cost of care. 

The webinar also highlights important equity considerations. Visual assessment alone can be less reliable in patients with darker skin tones, contributing to delayed detection and worse outcomes. Objective, biology-based measurement helps close this gap by providing consistent, unbiased data across all patient populations. 

From a financial and operational perspective, the impact is significant. Pressure injuries contribute to increased length of stay, readmissions, regulatory penalties, and legal exposure. By enabling earlier and more accurate detection, biology-based approaches can help organizations reduce harm while improving performance across quality and reimbursement programs. 

Ultimately, the message is simple but powerful: if pressure injuries are biological, prevention must be biological too. 

Watch the full webinar to explore how integrating objective, physiology-based assessment can transform your organization’s approach to pressure injury prevention and help move closer to the goal of zero harm.