VALENF-Instrument-Based Nursing Assessment and Early Occurrence of Hospital-Acquired Pressure Injuries and Falls among Hospitalized Adults

Background/Objectives: Pressure injuries and falls are frequent hospital adverse events. Identifying high-risk periods during hospitalization is essential for guiding effective prevention. In this study, we aimed to estimate the time from hospital admission to the occurrence of pressure injuries and/or falls and analyze its relationship with the nursing assessment at admission. Methods: A longitudinal observational study was conducted with a systematic sample of 314 adult patients admitted between January and May 2024. Survival analysis was performed to describe the temporal distribution of adverse events and compare their occurrence across nursing assessment variables using the log-rank test. Poisson Generalized Linear Models were applied to explore associated factors. Results: Fifteen pressure injuries and four falls were recorded. Overall, 63% of these adverse events occurred within the first five days of hospitalization. Patients with lower functional capacity (log-rank p<0.001) and high-pressure injury risk (log-rank p<0.001) according to the VALENF Instrument were more likely to acquire new pressure injuries. Similarly, fall risk scores (log-rank p=0.037) obtained with the same instrument were associated with falls. Patients classified as high risk for pressure injuries showed a nine-fold higher likelihood of developing new injuries (Wald χ2, p < 0.001), while urgent admission further increased this risk more than six-fold (Wald χ2, p = 0.015). Conclusions: This exploratory study highlights the value of early nursing assessment using the VALENF Instrument in identifying high-risk patients and planning timely, individualized preventive care during hospitalization.