DOI: 10.1371/journal.pone.0358073 ISSN: 1932-6203

Pressure injuries as adverse events in the context of patient’s safety during 2013–2020 in a specialist hospital: A retrospective study

Izabela Marcelina Sowińska, Sylwia Kocur, Mirosława Noppenberg, Grażyna Puto, Iwona Malinowska-Lipień, Agnieszka Gniadek

Background

Hospital-acquired pressure injuries (HAPIs) are recognized as potentially preventable adverse events and important indicators of patient safety and healthcare quality. However, evidence regarding their occurrence within hospital adverse event reporting systems remains limited.

Objective

To assess the occurrence of hospital-acquired pressure injuries recorded as adverse events and to identify factors associated with their occurrence.

Materials and methods

This retrospective study was conducted at a hospital in Kraków, Poland. A total of 1,272 adverse event reports recorded between 2013 and 2020 were reviewed. Among these, 305 hospital-acquired pressure injuries (HAPIs) were identified. A comparison group of hospitalized patients without HAPIs was selected for comparative analyses. Clinical and demographic information was extracted from patients’ medical records.

Results

Between 2013 and 2020, a total of 1,272 adverse events were recorded, representing 1.16% of all hospitalizations during the study period. Hospital-acquired pressure injuries (HAPIs) accounted for 24.0% (305/1,272) of all reported adverse events. Compared with the comparison group, patients with HAPIs had significantly longer hospital stays (18.64 ± 13.51 vs. 12.62 ± 7.81 days; p  < 0.001) and were prescribed a significantly higher number of medications (18.14 ± 9.03 vs. 10.43 ± 7.90; p  < 0.001). The highest number of adverse events was reported in the Internal Medicine and Allergology Ward. In multivariable analysis, older age, prolonged hospitalization, a higher number of prescribed medications, and greater comorbidity burden were independently associated with HAPI occurrence.

Conclusions

Hospital-acquired pressure injuries are recognized as an important indicator of patient safety and healthcare quality. Their occurrence was significantly associated with prolonged hospitalization and greater pharmacological burden, suggesting an increased risk among patients with higher clinical complexity. Systematic monitoring of HAPIs within hospital adverse event reporting systems may facilitate the identification of high-risk patients, support targeted preventive interventions, and contribute to improvements in patient safety.