Pressure injuries are a costly and complex global issue in all health-care settings. Morbidity and mortality are significant for persons who develop facility-acquired pressure injuries and they often fail to proceed through normal wound healing, stalling in the inflammatory phase of healing and remaining in a chronic inflammatory state. Prevention and treatment require multiple approaches and multidisciplinary team involvement for success. Prevention includes attention to risk assessment, daily skin assessment, tissue load management with offloading and support surfaces, mobility and activity interventions, nutrition assessment, and incontinence management. Treatment follows the TIMERS acronym: Tissue management including debridement and cleansing, Infection and inflammation control including management of bacterial biofilms, Moisture balance with use of moisture-retentive dressings, Epithelial edge advancement or frequent and consistent reassessment of healing, Repair and regeneration with use of advanced wound healing and adjunct therapies, and Social factors and those related to the individual.

As Medicare has focused more on hospital readmissions and care transitions over time, programs and movements aimed at providing geriatric-focused care have developed nationally. These programs aim to minimize and prevent hazards of hospitalization, decrease readmissions, provide safer transitions to the post-acute setting, and decrease length of stay while acknowledging and addressing specific care considerations of hospitalized older adults, such as dementia, sensory impairment, and mobility impairment. Inpatient geriatric assessments help providers tailor care plans to the specific needs of individual hospitalized older adults and determine their post-acute care needs, and also help with appropriate counseling of family and caregivers. Prevention measures are vital during hospitalization of older adults, who are at higher risk of delirium, pressure injury, falls, aspiration, malnutrition, sleep disturbances, and venous thromboembolism. Detailed transition plans and specialized discharge summaries are important to highlight the needs of older adults as they transition to post-acute care settings, and should allow for providers to resume the care plan seamlessly, including continuation of advanced care planning conversations.