Pressure injuries remain one of the most persistent forms of preventable harm in healthcare—despite decades of education, policies, and prevention bundles. In Bruin Biometrics’ recent webinar, What the Risk Score Can’t Tell You: Why “Low-Risk” Patients Still Get Pressure Injuries, Dr. Rhonda Sullivan explored why current prevention strategies continue to fall short and what clinical leaders can do differently.
You can view the full webinar here and read a summary below:
The problem with traditional risk assessment
Most organizations rely on subjective pressure injury risk assessment tools—most commonly the Braden Scale—to guide prevention. While widely used, these tools were never designed to function as definitive predictors of harm. Evidence shows they:
- Miss many of the strongest predictors of pressure injury risk
- Perform poorly in high-risk settings such as the ICU, ED, and perioperative environments
- Fail to reliably identify early tissue damage, particularly in patients with darker skin tones
The result is a system that often labels patients as “low risk” while tissue damage is already developing beneath the skin—unseen and untreated.
Why visual skin assessment isn’t enough
Pressure injuries begin below the skin surface, driven by pressure and shear that disrupt blood flow and damage tissue at the cellular level. This damage can progress for days before visible skin changes appear. By the time redness or breakdown is observed, injury severity and cost have already escalated.
This blind spot contributes to:
- Missed opportunities for early intervention
- Inconsistent prevention practices
- Ongoing variability in outcomes across units and facilities
A biology-based approach to prevention
During the webinar, Dr. Sullivan introduced sub-epidermal moisture (SEM) assessment to close this gap. SEM is an early biological marker of tissue stress that can be detected days before visible skin damage occurs.
The Provizio SEM Scanner enables clinicians to:
- Objectively identify early pressure-related tissue damage
- Guide anatomy-specific, patient-centered interventions
- Reassess whether prevention strategies are working in real time
By shifting from predicting who might be at risk to detecting where tissue injury is beginning, SEM assessment supports earlier action and more effective prevention.
If you’re exploring ways to strengthen pressure injury prevention, reduce preventable harm, and improve documentation and quality outcomes, contact us to learn more about SEM assessment and the Provizio SEM Scanner.