Bridging the gap: ICU nurses' experiences in detecting pressure injuries across diverse skin tones

Bridging the gap: ICU nurses' experiences in detecting pressure injuries across diverse skin tones Introduction: Pressure injuries (PIs) are a common yet serious concern in healthcare settings, often leading to increased patient distress, higher mortality rates, and prolonged stays in hospital or the intensive care unit (ICU).1,2 While international classification systems offer evidence-based strategies for prevention and management, early detection remains challenging-particularly for patients with darker skin tones, where erythema may not be visibly apparent.3,4 Timely and accurate assessment is crucial in preventing complications, making it essential for healthcare providers to recognise how PIs manifest across diverse skin tones and to adapt their evaluation techniques accordingly.4,5 Method: The study adopted a qualitative descriptive approach.Following ethical approval, ICU nurses who met the study inclusion criteria were interviewed in person using a semi-structured interview format.The interviews were audio recorded and transcribed verbatim.The collected data were managed using NVivo (v.14) (Lumivero, US), and analysed using thematic analysis.Results: A total of 11 ICU nurses took part in the study.Thematic analysis revealed three key themes.• The role of education: nurses emphasised the crucial role of education in preventing PIs.Many reported gaps in their undergraduate and professional training, leaving them underprepared to assess and manage PIs effectively.Inadequate knowledge often led to suboptimal patient care and hindered the implementation of evidence-based interventions • Skin tone disparity: participants highlighted a lack of diverse patient representation in educational materials, which primarily focus on lighter skin tones.This deficiency contributed to difficulties in recognising early-stage PIs in patients with darker skin tones.The participants linked late-stage PI detection to unconscious bias, limited multicultural education and knowledge gaps which they felt contributed to health disparities, patient discomfort and financial burdens.