What Are Hospital-Acquired Pressure Injuries (HAPIs)?

 

What Are Hospital-
Acquired Pressure
Injuries (HAPIs)?

Pressure on Patient's Back
Hospital-Acquired Pressure Injuries (HAPIs) are localized injuries to the skin and underlying tissue caused by prolonged pressure or shear during patient care.

Surgical patients are especially vulnerable because they often remain in one position for extended periods without the ability to reposition themselves.

Preventing pressure injuries in the operating room starts with early risk assessment, proper patient positioning, and the use of pressure-redistribution surfaces designed to protect skin integrity.
 

What Causes Pressure Injuries During Surgery?


Sustained pressure, friction, shear, heat, and moisture that compromise blood flow to vulnerable tissue are the main causes of pressure injuries during surgery.

Long procedure times and improper positioning can increase stress on bony prominences such as the sacrum, heels, shoulders, and head.

Without effective pressure management and positioning support, tissue damage can develop quickly and lead to costly postoperative complications.

Operating Room

High Risk Factors for HAPIs


Surgical patients face a higher risk for HAPIs because anesthesia limits movement and reduces the body’s natural response to discomfort or pressure.

Additional risk factors such as procedure length, high BMI, comorbidities, age, poor circulation, and elevated body temperature can further increase susceptibility to skin breakdown.

Following evidence-based perioperative guidelines and using advanced positioning solutions can help reduce the risk of pressure injuries throughout surgery.


Clock

Procedure Length

High BMI

High BMI

Charts

Comorbidities


The Price of Pressure

HAPIs Extend the Length of Stay in the OR and Increase Resource Utilization


$26.8 Billion
In Acute Costs
Accounts for 25% of all wasteful spending related to failures in healthcare delivery, according to U.S. CMS Director’s Office

2.5 Million
Cases Per Year
2nd most common diagnosis in health system billing records in the U.S.

$75,000-$150,000
Per Patient
Average cost to facility for a stage 3, 4, or unstageable pressure injury

60,000
Deaths Per Year
8th most frequent cause of death in U.S. based on CDC reporting

A Leading CMS Quality Measure


Hospital-Acquired Pressure Injuries (HAPIs) remain one of the most closely monitored indicators of healthcare quality. Through the Hospital-Acquired Condition Reduction Program (HACRP), CMS evaluates hospital performance on preventable conditions, including pressure injuries, as part of its broader effort to improve patient outcomes and reduce avoidable costs.

For perioperative teams, every positioning decision contributes to a larger quality strategy. Reducing pressure, friction, shear, heat, and moisture during surgery helps protect vulnerable tissue, supports skin integrity, and aligns with evidence-based patient safety initiatives.

By implementing proven positioning best practices and pressure-redistribution solutions, healthcare facilities can strengthen patient safety programs, support quality improvement efforts, and help reduce the clinical and financial burden associated with preventable pressure injuries.





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How to Achieve Safe Patient Positioning?

Arcs on Beach Chair
  • Proper patient positioning plays a critical role in pressure injury prevention by evenly distributing pressure and minimizing shear forces during surgery
  • Xodus Medical positioning solutions are designed to help stabilize patients securely while protecting vulnerable anatomy throughout a procedure
  • By combining reliable positioning support with pressure redistribution, surgical teams can improve patient safety, workflow consistency, and compliance with perioperative best-practices
Positioning Guide Example

Discover AORN Best Practices for Patient Positioning


Preventing HAPIs in surgery requires a proactive approach that combines risk assessment, proper positioning, skin protection, and ongoing staff education.

Best-practices include minimizing pressure points, reducing friction and shear, using pressure redistribution surfaces, and following perioperative guidelines from organizations such as AORN and NPIAP.

Xodus Medical solutions support these evidence-based strategies by helping clinicians maintain safer positioning, protect skin integrity, and improve patient outcomes.


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