What 59 CNOs Told Us About Tools, Time, and Zero Harm
Read on for highlights from the webinar and watch the full recording below. The complete 2026 CNO Pulse Report, with every survey finding and the five-dimension prevention readiness framework, is now available to download here.
Nursing leaders trust their teams to prevent pressure injuries. Far fewer trust the tools those teams are given. That was the headline finding from our October webinar, where Ryan Kraudel and Dr. Rhonda Sullivan of Bruin Biometrics shared an early look at the 2026 CNO Pulse survey of 59 chief nursing officers and nursing executives across 29 US states. The session also made a practical case: preventing pressure injuries can ease the burnout, staffing, and cost pressures that keep pushing prevention down the priority list. You can watch the full recording below.
Key Takeaways from the Webinar
- Sixty percent of CNOs are confident in their teams, yet only 25% say current risk and visual skin assessment tools are sufficient: a 35-point confidence gap.
- Every respondent described a detection or execution problem. None said their current approach works fully as is.
- Each pressure injury adds at least 28 hours of nursing work. At 51 injuries a year, that equals 1,428 hours, or about two thirds of a full-time nurse.
- Patients with dark skin tones have 1.8 times higher pressure injury incidence, and most CNOs are only moderately confident or less in detecting damage in these patients.
- Mandatory eCQM HH-PI reporting arrives in January 2028, and 85% of nursing executives do not yet have a finalized readiness plan.
Why the Gap Is Widest in High-Performing Hospitals
The gap was most pronounced where you might least expect it. In Magnet-designated hospitals and facilities with more than 500 beds, confidence in teams held at 56% and 63%, while only 8% in each group considered their tools sufficient. These subgroups were small, but the direction is clear.
Rhonda sees the same pattern nationally. Traditional skin assessments cannot reliably detect damage beneath intact skin, especially before visible changes appear and in patients with darker skin tones. Prevention bundles with as many as 27 interventions often see adherence of 50% or lower. National AHRQ data reflects the result: from 2016 to 2023, pressure injury rates rose about 8% while six of eight patient safety indicators fell by double digits.
The Hidden Workload and Cost Behind Every Injury
Ryan walked through a simple calculation any unit can repeat: multiply your annual hospital-acquired pressure injury count by 28 hours. Rhonda translated the 1,428-hour example into 119 twelve-hour shifts and roughly $67,000 in nursing wages. Most CNOs (64%) also estimate a single injury costs $20,000 or more to treat, yet that cost rarely appears as one line item. It is spread across nursing hours, longer stays, supplies, and legal risk.
Prevention as a Ripple Effect
The session closed with an encouraging reframe: fewer pressure injuries positively affect six of the concerns CNOs ranked highest, including burnout and retention, unreimbursed cost, infection risk, care consistency, and quality reporting readiness. Rhonda also shared findings from her recent SAWC poster: across more than 8,000 patients, SEM-guided prevention was associated with an 81.4% relative reduction in hospital-acquired pressure injuries, with several cohorts reaching zero.
Watch the full webinar below to see the complete data, Rhonda’s clinical perspective, and a five-dimension framework for moving from reactive to proactive prevention.