Nurse Leaders Trust Their Teams, Not Tools, to Prevent Pressure Injuries Leading Up to 2028 eCQM HH-PI Reporting Mandate

LOS ANGELES, October 29, 2026 – Chief Nursing Officers (CNOs) at large U.S. hospitals are confident in their nursing teams, but not in the tools those teams use to prevent pressure injuries, according to The Pressure Injury Prevention Confidence Gap, a national survey of 59 nursing leaders conducted in July 2026. Bruin Biometrics will present the full survey findings at the 2026 American Nurses Credentialing Center (ANCC) Magnet & Pathway Conference in Chicago, October 29-31, 2026, at booth 1168.

This gap is critical because Centers for Medicare & Medicaid Services (CMS) reporting of hospital-acquired pressure injuries becomes mandatory on January 1, 2028, under CMS826v2. Yet 85% of CNOs surveyed have no finalized readiness plan. 

Confidence in the Team. Risk and Skin and Tissue Assessments are Insufficient. 

Sixty percent of CNOs are confident their teams are doing everything they can to prevent pressure injuries. However, only a quarter of nursing leaders (25%) say their current risk and skin assessment tools are sufficient, and only when staff follow protocols consistently every shift. In addition, 22% said current processes can miss important early signs before skin changes are visible.

Magnet-designated medical facilities are certified by the American Nurses Credentialing Center (ANCC) as the gold standard for nursing practice, leadership, and patient care innovation. In Magnet-designated hospitals, the gap is even wider, with 56% of CNO’s confident their teams are doing everything they can to prevent pressure injuries, while only 8% of their current risk and skin assessment tools are sufficient. 

Detecting Pressure Injuries Exposes Nurses to Blame. 

Nurses look for the earliest signs of pressure injuries with visual skin assessments, checking for visible signs of tissue damage where skin is most likely to break down. However, the tissue damage that leads to pressure injuries, known as the pressure injury damage cascade,  begins beneath the skin, typically 3-10 days before damage is visible. As a result, the current way of assessing patients puts nurses behind the curve, no matter how consistently they are checking for pressure injuries.

A High-Stakes Problem Buried by Nursing Workflow Demands to “Do More” 

Pressure injuries are the most common adverse event among hospitalized Medicare patients. They account for 34% of all adverse events in 2023, impacting 2.5 million US patients per year, 60,000 of whom die from pressure injury-related causes. 

It’s therefore understandable why 81% of CNO’s say reducing pressure injuries is extremely or very important to them personally. However, CNOs ranked hospital-acquired pressure injuries ninth of 13 in listing their “most pressing concerns” (19%), well behind nurse burnout (73%), recruiting and retention (71%), and rising costs (56%). Pressure injury prevention appears to be crowded out by other priorities on overloaded nursing leaders’ priority lists.

The Rising Cost and January 2028 Cliff

Soon, pressure injuries can reduce hospital reimbursement. Beginning January 1, 2028, every U.S. hospital must report the Hospital Harm, Pressure Injury electronic clinical quality measure (eCQM) through the CMS Hospital Inpatient Quality Reporting Program. Hospitals missing the program’s reporting requirements face a 25% reduction in their annual Medicare payment update, known as the market basket update. 

“Nurse leaders are not neglecting pressure injuries. They are juggling them with every other priority on their list,” said Martin Burns, CEO of Bruin Biometrics. “The cost shows up as nursing hours, overtime, and turnover, so it rarely gets counted as a pressure injury problem. The eCQM HH-PI reporting in January 2028 will make it highly visible. Hospitals and nursing leaders need to start planning now.”

Get the Report and Readiness Review

The full report, CNO Pulse: The Pressure Injury Prevention Confidence Gap, is available at https://bruinbiometrics.com/resources/pressure-injury-prevention-cno-survey. Hospital leaders can request a complimentary 30-minute pressure injury readiness review with the Bruin Biometrics clinical team at https://bruinbiometrics.com/contact/ or meet the team at Magnet booth 1168.

Survey Design

Researchscape International conducted the online survey from July 2 to July 30, 2026, on behalf of Bruin Biometrics. Fifty-nine CNOs and senior nursing leaders at U.S. hospitals across 29 states responded. Fifty-seven (57) percent of respondents have been a CNO or equivalent executive nursing leader for more than 10 years. Results are unweighted. Question bases range from 48 to 59. The full report lists the base for each figure.

About Bruin Biometrics

Bruin Biometrics is a medical device company transforming pressure injury prevention through objective, physiologically based assessment. The Provizio® SEM Scanner uses biocapacitance to identify and measure changes in localized tissue fluid associated with pressure-induced damage before those changes become visible at the skin’s surface. It helps clinicians detect early tissue damage, direct anatomically targeted care, monitor tissue response, and pursue the defining endpoint of prevention: keeping skin intact. For more information, visit www.bruinbiometrics.com.