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hospital admission, deep-tissue pressure injury, hospital-acquired pressure injury, long-wave infrared thermography, pressure injury, revenue preservation, thermal anomaly, thermal imaging



  1. Koerner, Suzanne BSN, RN, CWOCN
  2. Adams, Diane BSN, RN, CWCN
  3. Harper, Scot L. PhD, MD
  4. Black, Joyce M. PhD, RN, FAAN
  5. Langemo, Diane K. PhD, RN, FAAN


ABSTRACT: A deep-tissue pressure injury (DTPI) is a serious type of pressure injury that begins in tissue over bony prominences and can lead to the development of hospital-acquired pressure injuries (HAPIs). Using a commercially available thermal imaging system, study authors documented a total of 12 thermal anomalies in 9 of 114 patients at the time of admission to one of the study institution's ICUs over a 2-month period. An intensive, proven wound prevention protocol was immediately implemented for each of these patients. Of these 12 anomalies, 2 ultimately manifested as visually identifiable DTPIs. This represented a 60% reduction in the authors' institution's historical DTPIs/HAPI rate. Because these DTPIs were documented as present on admission using the thermal imaging tool, researchers avoided a revenue loss associated with nonreimbursed costs of care and also estimated financial benefits associated with litigation expenses known to be generated with HAPIs.


Using thermal imaging to document DTPIs when patients present has the potential to significantly reduce expenses associated with pressure injury litigation. The clinical and financial benefits of early documentation of skin surface thermal anomalies in anatomical areas of interest are significant.