A Retrospective Cohort Study of patient education programs in hospitalized elderly patients with hospital-acquired pressure ulcers

Background: Hospital-acquired pressure ulcers (HAPUs) remain among the most common preventable harms in hospitalized older adults, and structured patient education is widely recommended within multicomponent prevention bundles, yet its independent association with HAPU incidence in elderly cohorts is less characterized than staff-directed interventions. Objective: This retrospective cohort study examined whether a structured patient education program was associated with lower HAPU incidence, later ulcer onset, and less severe ulcer staging among hospitalized patients aged 65 and older. Methods: We reviewed records for elderly medical and surgical inpatients over a three-year period, comparing HAPU incidence, time to first ulcer, and ulcer stage between patients given a bedside education program on repositioning, skin inspection, and nutrition, and those given usual care, using logistic regression adjusted for Braden score, comorbidity, and mobility. Results: Education-group patients had significantly lower HAPU incidence than usual-care patients (7.4% vs 14.9%, adjusted OR 0.52, 95% CI 0.38-0.71), longer time to ulcer onset, and more stage 1 rather than higher-stage ulcers among those affected; the association remained significant after adjustment. Conclusions: Structured patient education was independently associated with reduced HAPU incidence and less severe staging, supporting it as a low-cost component of multicomponent HAPU prevention programs for hospitalized elderly patients.