Pressure Injury Survey Guide

Conduct the Study - Chart Review



Admission Skin and Pressure Injury Risk Assessments


A skin assessment and a pressure injury risk assessment should be completed and documented in the medical record as soon as possible after patient arrival at the facility.

  • A physical assessment must be completed within 24 hours of hospital admission in accordance with The Joint Commission regulations. T his physical assessment should include a skin assessment and a pressure injury risk assessment.
  • The NDNQI standard for documentation of admission skin assessment and pressure injury risk assessment is within 24 hours of admission
  • The IHI and HRET recommend that these assessments be completed within 4 hours of admission and the 2014 International Pressure Ulcer Guideline recommends within 8 hours.
  • Regardless of the time of documentation, pressure injury risk factors should be addressed as soon as they are identified.
  • Skin and pressure injury risk assessments are now routinely performed in the Emergency Department (ED) as a starting point for pressure injury prevention protocols.
  • In the United States, arrival to an inpatient acute rehabilitation unit is considered a new facility admission even if “transferred” from an acute care hospital.

Early and comprehensive assessment of the skin will identify pressure injuries present on admission.


Existing pressure injuries are a risk factor for addition pressure injuries.


  1. Health Research and Education Trust. (2016). Hospital Acquired Pressure Ulcers (HAPU) Change Packet: 2016 Update. Retrieved from http://www.hret-hen.org/topics/pu/HRETHENPRU_ChangePackage.pdf
  2. Institute for Healthcare Improvement. (2011). How-to Guide: Prevent Pressure Ulcers. Retrieved from http://www.ihi.org/resources/Pages/Tools/HowtoGuidePreventPressureUlcers.aspx
  3. National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, & Pan Pacific Pressure Injury Alliance. (2014). Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline (E. Haesler Ed.). Osborne Park, Western Australia: Cambridge Media.