Effective Preventive Strategies for Pressure Injuries in Neonatal and Pediatric Intensive Care: Analysis of an Implemented Pathway

Introduction. This descriptive observational study aimed to assess the impact of a structured pressure injury (PI) prevention program on the incidence of PIs in critically ill neonatal and pediatric patients implemented in the Neonatal and Pediatric Intensive Care Unit of the IRCCS Istituto Giannina Gaslini. The program, coordinated by a nurse specialized in wound care, included the use of pediatric risk assessment tools (Braden, Braden Q, and Glamorgan scales), evidence-based protocols, frequent repositioning, support surfaces, and targeted staff training. Methods. The primary objective was to assess the impact of these interventions on the incidence of PIs. Prospective data collection was carried out to document the implementation of the measures and the progression of PIs. Results. A direct comparison between data collected prior to the systematic introduction of preventive strategies (incidence rate: 5.6%) and data collected after program implementation (average incidence rate: 1.6%) revealed an overall 71% reduction in PI cases. Discussion. The program’s success appears to be linked to a multifactorial approach: systematic risk assessment, continuous staff training, and the use of appropriate support devices and dressings. The role of the wound care nurse proved essential for clinical supervision and team engagement. However, fluctuations in incidence rates during staff turnover periods highlight the need for sustained education and a strong culture of prevention. The variable application of risk assessment tools also suggests that standardized use and interpretation should be promoted to improve consistency. Conclusions. The adoption of a structured, multidisciplinary program—with the involvement of a wound care specialist nurse and the use of pediatric-specific assessment tools—appears promising in reducing the incidence of pressure injuries in critically ill neonatal and pediatric patients. Further prospective studies are needed to confirm these results and to identify specific risk predictors.