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Purpose: To demonstrate the importance of comprehensive skin observation as an effective intervention for pressure injury prevention in elderly long-term care hospital patients. Methods: The survey was conducted with 70 nursing staff members working at two long-term care hospitals with 200 beds or less in D city. Data were collected from October 16 to October 23, 2019 and analyzed using descriptive statistics, the chi-square test, and the independent t-test with the SPSS 25.0 program. Results: Nursing care knowledge for pressure injury was similar between the two groups. Conversely, nursing care performance for pressure injury degree of the nursing staff in the hospital using skin observation records performed better than those who did not (t=6.11, p<.001). Furthermore, comprehensive skin assessments in long-term care hospitals using skin observation records showed a lower incidence rate of pressure injury than that showed using general skin assessments (t=-5.28, p=.006). Conclusions: Comprehensive skin assessment is important for pressure injury prevention in elderly long-term care hospital patients. To implement this effectively, it is necessary to devise institutional regulations, guidelines, and systematic education programs.