Artificial Intelligence-Supported Pressure Injury Prevention and Care in Intensive Care Patients

Ankara Yildirim Beyazıt University174 enrolled

Overview

This study evaluates the effect of an artificial intelligence-supported mobile application, PRESS AI, on pressure injury prevention and nursing care in adult intensive care patients. The application supports nurses in pressure injury risk assessment, wound assessment and staging, and selection of appropriate prevention and care interventions. The study compares the incidence of hospital-acquired pressure injuries before and after the implementation of PRESS AI. During the pre-intervention period, patients receive routine pressure injury prevention and nursing care. During the intervention period, nurses use PRESS AI together with an integrated pressure injury prevention and care algorithm to support clinical assessment and care planning.

This interventional before-and-after study is conducted in the Anesthesiology and Reanimation Intensive Care Unit of Ankara University Ibni Sina Research and Application Hospital. Adult patients meeting the eligibility criteria are included during the pre-intervention and intervention periods. The pre-intervention period is conducted from March 1, 2026, to May 31, 2026. During this period, pressure injury risk assessment, skin assessment, prevention, and nursing care are performed according to routine clinical practice. PRESS AI is not used during this period. Following a training and implementation period in June 2026, PRESS AI is introduced into clinical practice. The intervention period is conducted from July 1, 2026, to September 30, 2026. PRESS AI incorporates Braden Scale risk assessment, skin and wound assessment, artificial intelligence-supported image analysis for pressure injury staging, and a pressure injury prevention and care algorithm to support nursing care planning. The artificial intelligence-generated staging recommendation is used as clinical decision support and does not replace the nurse's clinical judgment. The final pressure injury stage is determined by the nurse. Patients are followed daily for the development of new pressure injuries during their intensive care stay. The incidence of hospital-acquired pressure injuries during the pre-intervention and intervention periods is compared to evaluate the effectiveness of the PRESS AI-supported approach.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

Interventions

PRESS AI-Supported Nursing CareOTHER

PRESS AI is an artificial intelligence-supported mobile clinical decision support application integrated with a pressure injury prevention and care algorithm. It supports nurses in Braden Scale risk assessment, skin and wound assessment, artificial intelligence-assisted pressure injury staging, and the planning and documentation of individualized pressure injury prevention and care interventions. Artificial intelligence-generated staging recommendations are used to support clinical decision-making and do not replace nurses' clinical judgment. The final pressure injury stage is determined by the nurse based on clinical assessment.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Aged 18 years or older. * Hospitalized in the Anesthesiology and Reanimation Intensive Care Unit of Ankara University Ibni Sina Research and Application Hospital during the pre-intervention or intervention period. * Written informed consent provided by the patient or, when the patient lacks decision-making capacity, by the patient's legally authorized representative. Exclusion Criteria: * Refusal to participate by the patient or legally authorized representative, or withdrawal of previously provided consent. * Missing essential follow-up data required to assess the development of pressure injuries.

Outcomes

Primary Outcomes

Incidence of Hospital-Acquired Pressure Injuries

The incidence of hospital-acquired pressure injuries will be determined based on newly developed pressure injuries during the intensive care unit stay. Patients will be assessed daily for pressure injury development, including the date of occurrence, anatomical location, and stage. The incidence during the pre-intervention period will be compared with the incidence during the PRESS AI intervention period.

Time frame: Daily during each participant's intensive care unit stay; assessed over the 3-month pre-intervention period (March 1-May 31, 2026) and the 3-month intervention period (July 1-September 30, 2026).

Secondary Outcomes

Distribution of Pressure Injury Stages

Newly developed hospital-acquired pressure injuries will be classified according to pressure injury stage. The number and proportion of pressure injuries in each stage will be determined and compared between the pre-intervention and PRESS AI intervention periods.

Anatomical Distribution of Pressure Injuries

The anatomical locations of newly developed hospital-acquired pressure injuries will be recorded. The number and proportion of pressure injuries according to anatomical location will be determined and compared between the pre-intervention and PRESS AI intervention periods.

Time to Development of Pressure Injury

The time from admission to the intensive care unit to the development of a new hospital-acquired pressure injury will be recorded in days for patients who develop a pressure injury. The time to pressure injury development will be evaluated and compared between the pre-intervention and PRESS AI intervention periods.

Time frame: From intensive care unit admission until the first occurrence of a hospital-acquired pressure injury or intensive care unit discharge, whichever occurs first, during the 3-month pre-intervention and 3-month intervention periods.