Challenging assumptions on prevention of pressure injuries.

Pressure injuries have long been framed as being largely preventable through appropriate nursing interventions. However, emerging evidence challenges this assumption, highlighting systemic, physiological and patient-specific factors that contribute to their development and progression, many of which lie beyond nursing control. Pressure ulcers can result from patient pathophysiology, with the growing recognition of skin failure as a distinct phenomenon. Evidence can be lacking around nursing interventions, such as repositioning, dressings and risk assessment tools; additionally, the high expectations placed on nurses are not justified by scientific evidence. There should be a shift away from a blame-based approach and overconfidence in the value of nursing interventions towards a more nuanced understanding of pressure injuries prevention as a complex, multifactorial challenge in need of further research attention.