Pressure ulcer prevention in hospitals: AHRQ’s bundle and where PT and OT come in
The Agency for Healthcare Research and Quality (AHRQ) toolkit on preventing pressure ulcers in hospitals calls prevention “multidisciplinary,” naming physical therapists among those who “need to be invested,” and says “Physical and occupational therapists, dietary staff, and others are important contributors to pressure ulcer prevention.” It describes a three-part bundle: skin assessment, risk assessment, and care planning. This page quotes AHRQ only and uses AHRQ’s term, “pressure ulcer.”
Quoted from official pages checked November 12, 2026. Confirm current information on those sites. This page is not medical advice and does not describe any patient’s care.
Sources read on November 12, 2026: chapter 3 of AHRQ’s toolkit, What are the best practices in pressure ulcer prevention that we want to use? and its continuation (both marked “Content last reviewed October 2014”). These are older pages; check AHRQ for newer information.
Why it takes a team
AHRQ lists what makes prevention hard. The first: “Nurses, physicians, dieticians, physical therapists, and patients and families are among those who need to be invested.” On care planning, it says: “The plan of care should be interdisciplinary. It is not just the nursing staff that develops and implements treatment plans. Physical and occupational therapists, dietary staff, and others are important contributors to pressure ulcer prevention and need to be an integral component of the care planning process.”
The bundle
AHRQ states: “The pressure ulcer bundle outlined in this section incorporates three critical components in preventing pressure ulcers:” They are “Comprehensive skin assessment.”, “Standardized pressure ulcer risk assessment.”, and “Care planning and implementation to address areas of risk.”
Skin assessment
AHRQ states: “Comprehensive skin assessment is a process by which the entire skin of every individual is examined for any abnormalities.” And: “In most hospital settings, comprehensive skin assessment should be performed by a unit nurse on admission to the unit, daily, and on transfer or discharge.”
Risk assessment
AHRQ names two widely used scales: “the Norton Scale and the Braden Scale.” It says the Braden Scale “is made up of six subscales (sensory perception, moisture, activity, mobility, nutrition, friction/shear)”. It adds: “What is critical is not which scale is used but just that some validated scale is used in conjunction with a consideration of other risk factors not captured by the risk assessment tool.” No scale is copied here.
Care planning
AHRQ states: “Once risk assessment has helped identify patient risk factors, it is important to match care planning to those needs. This includes planning for any risks found on the risk assessment tool, such as nutrition, activity, mobility, moisture, and friction/shear, as well as any additional risk factors.” And: “Any area of risk should have a corresponding plan of care”.
On repositioning: “Frequent small repositioning shifts can help prevent pressure ulcers.” For patients in pain after surgery, it suggests: “Sit the person in a chair. This maintains the more elevated position and allows for small shifts in weight every 15 minutes.”
The chapters read are written for hospitals; this page does not apply them to other settings.
What this page does not do
It does not copy AHRQ’s tools, scales, or care plan forms. It is not medical advice and does not recommend any treatment, medicine, or product. Scope of practice for each profession is set by state law; check your state board.