From risk scores to prevention action: the development of BEPU2025 to standardise and optimise pressure ulcer risk assessment and prevention in Belgium

Abstract

OBJECTIVE: Effective pressure ulcer (PU) prevention requires the timely identification of patients at risk and the prompt implementation of appropriate preventive interventions. However, many PU risk assessment instruments are complex, time-consuming and difficult to integrate into routine clinical workflows, potentially limiting their uptake in practice. METHOD: In Belgium, these challenges led to the initiation of the Belgian Pressure Ulcer Risk Assessment project in 2016, which aimed to develop a clinically feasible approach to PU risk assessment and prevention. Building on the experiences of the earlier local assessment tools BEPU2016 and UZL-RWD2017, BEPU2025 was developed as a nationally aligned pressure risk assessment and prevention approach that integrates risk assessment, daily reassessment and structured PU prevention pathways within routine care processes. RESULTS: Rather than generating numerical risk scores, BEPU2025 focuses on supporting prevention-oriented clinical decision-making through rapid and repeated assessment of risk. Developed through almost a decade of Belgian quality improvement initiatives, BEPU2025 combines a concise assessment framework with workflow integration, electronic patient record implementation and a strong emphasis on nurse-led prevention. CONCLUSION: This viewpoint argues for a shift from score-based risk assessment towards a dynamic, prevention-oriented approach embedded within routine care processes. Further research is needed to evaluate its impact on clinical outcomes and its applicability in other healthcare settings.

The authors' abstract, as published at the source. Journal of Wound Care, 2026 · DOI ↗