Hospital-acquired pressure injuries (HAPIs) affect approximately 2.5 million patients annually in the U.S. and cost between $9,000 and $150,000 per injury to treat, according to AHRQ estimates. Since 2008, CMS has not reimbursed hospitals for Stage 3 and Stage 4 HAPIs acquired during inpatient care — making this both a patient safety and a financial priority for every hospital system. For nursing students, pressure injury prevention is one of the cleanest capstone topics: the causal pathway from nursing assessment to prevention to outcome is direct, the evidence is robust, and the Braden Scale gives you a validated assessment tool to anchor your intervention.
Terminology: pressure injuries vs pressure ulcers
The correct current term is pressure injury, updated by the National Pressure Injury Advisory Panel (NPIAP, formerly NPUAP) in 2016. Previous literature uses "pressure ulcer" and "decubitus ulcer" — all three terms refer to the same condition. When searching literature, include all three terms. In your capstone, use "pressure injury" as your primary term to reflect current clinical standards.
HAPU vs CAPU: a critical distinction for your PICOT
Faculty look for this distinction. Your capstone should specify which type your project addresses:
| Term | Meaning | Capstone relevance |
|---|---|---|
| HAPI (Hospital-Acquired Pressure Injury) | Pressure injury that develops during the current hospitalization; was not present on admission | The primary focus for most inpatient nursing capstones; directly tied to nursing care quality |
| CAPU (Community-Acquired Pressure Ulcer) | Present on admission; developed before hospitalization | Relevant for admission assessment and staging accuracy projects; not a "preventable" harm in the same sense |
PICOT examples for pressure injury prevention
From generic to strong
Too broad: In hospitalized patients, does turning reduce pressure ulcers compared to no turning schedule within 3 months?
Acceptable: In adult ICU patients, does a structured 2-hour repositioning protocol reduce HAPI incidence compared to standard nursing care over 90 days?
Strong: In adult patients with a Braden Scale score ≤18 admitted to a medical-surgical unit, does a nurse-initiated prevention bundle (2-hour repositioning, barrier cream application, and nutritional assessment referral) reduce Stage 2+ HAPI incidence compared to current standard care over a 90-day pilot?
The Braden Scale in your capstone
The Braden Scale for Predicting Pressure Sore Risk is the most validated risk assessment tool in nursing — used in virtually every U.S. hospital. It scores six subscales: sensory perception, moisture, activity, mobility, nutrition, and friction/shear. Scores ≤18 indicate risk; ≤12 indicates high risk.
In a capstone, the Braden Scale functions as your population identifier (patients scoring below a threshold), your implementation trigger (score triggers the prevention bundle), and your audit tool (tracking whether high-risk patients received appropriate interventions). Using the Braden Scale in all three roles makes your implementation plan coherent and measurable.
Get help with your pressure injury capstone
Share your PICOT, unit setting, and Braden Scale threshold. Your writer builds a full evidence-based proposal to your program's rubric.
Start your project Compare: fall preventionEvidence sources and key guidelines
- NPIAP Clinical Practice Guidelines — the authoritative international standard for pressure injury prevention and treatment; updated 2019; cite this for any intervention recommendation
- AHRQ Preventing Pressure Ulcers in Hospitals Toolkit — practical implementation guide with evidence grading; excellent for your implementation plan section
- Wound, Ostomy and Continence Nurses Society (WOCN) — clinical practice guidelines and position statements
- NDNQI — national benchmarking data for HAPI rates by unit type; use to establish clinical significance with real numbers
- CINAHL search terms: "hospital-acquired pressure injury prevention," "Braden Scale nursing intervention," "pressure injury bundle," "repositioning protocol pressure ulcer"
Related guides
Pressure injury capstone FAQ
Use "pressure injury" as your primary term throughout the paper — this reflects the 2016 NPIAP terminology update and shows faculty you are current with clinical standards. When citing older literature that uses "pressure ulcer," you can note in a brief parenthetical that the terms are equivalent, or simply cite the source accurately with its original terminology without changing it.
No. Pressure injury prevention is a bedside nursing responsibility — positioning, skin assessment, moisture management, and nutritional screening are all standard nursing competencies. Your capstone focuses on the prevention protocol, not wound treatment. If your project addresses wound care for existing injuries, that is a different (and more complex) scope.
Most capstone projects target Stage 1 and Stage 2 HAPI prevention — these are the most preventable, the most common, and the most directly responsive to nursing interventions. Stage 3 and 4 injuries are less common and more complex; a proposal focused on preventing Stage 1–2 progression is more feasible and better supported by the Braden Scale intervention evidence.