Pressure injury prevalence in critical care settings: An observational pre-post intervention study.

It was a before-after observational study without randomisation, so other changes over time could explain the lower post-intervention prevalence. The intervention included several components delivered together, including presentations, bedside case discussions, printed resources, repeated visits, and unit manager and education support, so the contribution of any single component cannot be separated. Nursing care prevention processes were not analysed because baseline process data were not collected due to COVID-19 travel restrictions. The study did not collect disease severity, mechanical ventilation days, comorbidities, medications or vasopressors, so important pressure injury risk factors may be missing. Blood biomarkers were taken from available records rather than timed to admission or pressure injury onset. Data were collected on one day in each unit, so the results describe prevalence on that day rather than each patient's risk over the whole stay. The sample was 181 patients across three hospitals, and the authors note variability in length of stay and small sample size may limit statistical power. Post-intervention prevalence remained higher than international rates reported in the Discussion.

Do not read the drop from 60.9% to 28.7% as proof that nurse education alone prevented pressure injuries. This was a before-after observational study with several intervention components, no concurrent control, and nursing care processes were not analysed.