Iranian nurses' knowledge, attitude and behaviour on skin care, prevention and management of pressure injury: A descriptive cross-sectional study

Barriers and facilitators of adherence to evidence-based pressure injury prevention clinical practice guideline among intensive care nurses: A cross-sectional survey

OBJECTIVE

To explore intensive care unit (ICU) nurses' perceptions of their adherence to pressure injury prevention clinical practice guideline and identify the perceived barriers and facilitators that influence evidence-based pressure injury prevention practices in Chinese tertiary hospitals.

RESEARCH METHODOLOGY/DESIGN

This was a multi-site, quantitative, cross-sectional study. Data were collected using a self-report questionnaire with three sections: participant demographic information, adherence to pressure injury prevention clinical practice guideline, and barriers to and facilitators of pressure injury prevention clinical practice guideline implementation.

SETTING

Thirty-three adult ICUs in 16 tertiary general hospitals in 5 major cities in Liaoning Province, China.

RESULTS

In total, 473 nurses responded to the survey. The mean score for adherence to pressure injury prevention clinical practice guideline was 159.06 ± 20.65, with 65.3 % reporting good adherence. Multiple stepwise regression analysis indicated that smaller ICU size (β = -0.114, p = 0.012) and having participated in training on pressure injury prevention clinical practice guideline (β = 0.149, p = 0.001) were statistically significantly associated with better adherence. ICU nurses identified the low priority given to pressure injury prevention as the top barrier. The top three facilitators were awareness of evidence-based practice, the current documentation format for pressure injury risk/nursing interventions, and leadership support.

CONCLUSION

ICU nurses' adherence to pressure injury prevention clinical practice guideline was satisfactory, and they reported low-to-moderate barriers and moderate facilitators.

IMPLICATIONS FOR CLINICAL PRACTICE

Participating in training on pressure injury prevention clinical practice guideline was a predictor of ICU nurses' adherence. Therefore, it is highly recommended that healthcare organisations consider providing training to nurses and address the barriers identified to improve nurses' adherence to evidence-based pressure injury prevention guidelines.

Protective Health Behaviors among Critical Care Nurses Concerning Pressure Ulcer Prevention for Hospitalized Patients at Baghdad Teaching Hospitals

Background: Pressure ulcers remain a serious complication for immobile patients and a burden for healthcare professionals. Objectives: To assess health behavior prevention among critical care nurses regarding pressure ulcer prevention for hospitalized patients and to find out the relationship between critical care nurses health behavior prevention and sociodemographic variables. Methods: A cross-sectional design study was carried out in critical care units at three teaching hospitals. The study period extended from November 1, 2022, to January 28, 2023. Non-probability purposive sampling, whose target population was 100 nurses who work in critical care units in Baghdad, Iraq. The data were collected using a self-administered questionnaire. The data was collected from November 10th through December 23rd, 2022. Study instruments consist of two parts. First, the demographic sheet included sociodemographic information about the participants. The second part includes nurses’ attitudes toward the pressure ulcer prevention instrument (APuP). The collected data was analyzed using SPSS version 26. Results: Findings of the current study showed nearly three-quarters (74%) of critical care nurses had positive health behaviors regarding pressure ulcer prevention based on a total mean score of 2.26. Conclusion: This study concluded that the critical care units’ nurses surveyed in this study demonstrate an acceptable level of knowledge regarding pressure ulcer prevention and treatment. Continuing education or in-service training should be provided to enhance critical care units’ nurses’ practices and positive health behaviors about pressure ulcer prevention.

Model construction of factors influencing intensive care unit nurses' medical device-related pressure injury knowledge, attitude, and practice

The ability of knowledge, attitude, and practice of intensive care unit (ICU) nurses to perform medical device-related pressure injuries (MDRPIs) can affect the incidence of MDRPI in ICU patients. Therefore, in order to improve ICU nurses' understanding and nursing ability of MDRPIs, we investigated the non-linear relationship (synergistic and superimposed relationships) between the factors influencing ICU nurses' ability of knowledge, attitude, and practice. A Clinical Nurses' Knowledge, Attitude, and Practice Questionnaire for the Prevention of MDRPI in Critically Ill Patients was administered to 322 ICU nurses from tertiary hospitals in China from January 1, 2022 to June 31, 2022. After the questionnaire was distributed, the data were collected and sorted out, and the corresponding statistical analysis and modelling software was used to analyse the data. IBM SPSS 25.0 software was used to conduct Single factor analysis and Logistic regression analysis on the data, so as to screen the statistically significant influencing factors. IBM SPSS Modeler18.0 software was used to construct a decision tree model of the factors influencing MDRPI knowledge, attitude, and practice of ICU nurses, and ROC curves were plotted to analyse the accuracy of the model. The results showed that the overall passing rate of ICU nurses' knowledge, attitude, and practice score was 72%. The statistically significant predictor variables ranked in importance were education background (0.35), training (0.31), years of working (0.24), and professional title (0.10). AUC = 0.718, model prediction performance is good. There is a synergistic and superimposed relationship between high education background, attended training, high years of working and high professional title. Nurses with the above factors have strong MDRPI knowledge, attitude, and practice ability. Therefore, nursing managers can develop a reasonable and effective scheduling system and MDRPI training program based on the study results. The ultimate goal is to improve the ability of ICU nurses to know and act on MDRPI and to reduce the incidence of MDRPI in ICU patients.

Barriers and facilitators to pressure injury prevention in hospitals: A mixed methods systematic review

OBJECTIVE

To systematically synthesize research evidence on barriers and facilitators to pressure injury prevention in hospital settings.

METHODS

A systematic literature review of quantitative, qualitative, and mixed methods research was undertaken using PubMed, MEDLINE, Embase, CINAHL, and Cochrane Library. Studies that reported barriers or/and facilitators to pressure injury prevention in the acute care settings and published in English from 2008 to 2022 were included. Studies were excluded if they were conducted in residential care facilities and nursing homes, or other long-term community care settings. Two authors independently screened articles against the inclusion and exclusion criteria. Quality appraisal was conducted by two authors by using the Mixed Methods Appraisal Tool. Reported results were mapped to the Theoretical Domains Framework to identify the barriers and facilitators to pressure injury prevention.

RESULTS

A total of 78 studies were included. There were 65 quantitative studies, 11 qualitative studies, and two mix-methods studies. The most salient Theoretical Domains Framework domains identified in this review were "Knowledge", "Skills", "Environmental Context and Resources", "Optimism", "Social/Professional Role and Identity", and "Social influences".

CONCLUSION

The barriers and facilitators to pressure injury prevention in hospital settings identified in this systematic review were diverse, and included issues at both individual and organizational level. Healthcare organizations can address the barriers and facilitators from the influential Theoretical Domains Framework domains. Future research is required to investigate the effectiveness of behaviour change interventions that specifically target these barriers and facilitators to pressure injury prevention.

Nurses' Knowledge Concerning Prevention and Treatment of Pressure Ulcers

Pressure ulcers have high prevalence in patients and can be prevented with proper nursing interventions. The aim of this study was to evaluate nurses' knowledge about prevention and treatment of pressure ulcers. The present study was conducted with 111 nurses working in a General hospital in Greece. In this study, nurses had adequate knowledge about prevention and treatment of pressure ulcers. Respondents answered correctly in questions about staging of pressure ulcers (98.2%, 98.2%, 99.1%, 97.3%, 93.7%), the role of changing position in prevention of pressure ulcer (97.3%), the use of foam mattress (85.6%) and stretched sheets (92.8%), the use of antiseptic solution (95.5%, 85.6%), and interventions to reduce pressure on patients' heels (88.3%). A number of participants had adequate level of knowledge in the questions about the role of diet in healing of pressure ulcers (71.2%), products or devices for prevention or treatment of pressure ulcers (61.3%, 36.9%), healing of pressure ulcers (58.6%, 46.8%), prevention of bone pressure ulcers (31.5%), cleaning of a pressure ulcer (52.3%), and the role of low blood pressure as a risk factor for pressure ulcer (55.9%). However, the development of educational programs can help nurses to improve their knowledge about prevention and treatment of pressure ulcers.

Students' knowledge, attitude and practices towards pressure ulcer prevention and management

Background

Student nurses provide nursing care to patients during clinical allocation, and their competence may affect the quality of care given to the patients. Good knowledge and positive attitudes enhance early detection for prevention and management of pressure ulcers.

Aim

To determine undergraduate nursing students' knowledge, attitude and practices (KAP) towards prevention and management of pressure ulcers.

Setting

A nursing education institution in Windhoek, Namibia.

Methods

A quantitative, cross-sectional research design was used to conveniently sample (n = 50) student nurses and collect data using a self-administered questionnaire. Data were analysed using the statistical software programme (SPSS) version 27. Descriptive frequencies were applied, and Fishers exact test was performed. A statistical value of p < 0.05 was considered significant.

Results

Fifty (n = 50) student nurses consented to participate in the study. Student nurses reported good levels of knowledge (n = 35; 70%), attitude (n = 39; 78%), practices (n = 47; 94%). There was no statistically significant association between demographic variables and the level of knowledge, attitudes and practices, p > 0.05.

Conclusion

Student nurses have good knowledge, positive attitudes and practices on prevention and management of pressure ulcers. By the implications, the study concludes that the nursing students will competently manage the pressure ulcers occurring in the clinical setting. An observational study is recommended to assess practices in the clinical setting.

Contribution

The findings of this study will help to close the gap in the implementation of standard operating procedures for the prevention and management of pressure ulcers.

Development and validation of a questionnaire to evaluate the knowledge, attitude, behaviour and care preference of family members of Chinese older adults related to palliative care

AIM

To develop and validate a questionnaire on knowledge, attitude, behaviour and care preference of family members of Chinese older adults related to palliative care.

DESIGN

A descriptive study design and STROBE checklist were applied in this research.

METHODS

The theoretical framework of the questionnaire was knowledge-attitude-behaviour model. An additional dimension of palliative care preference of family members was set up in the questionnaire. Items were generated from a rapid review of international literature and interviews with 61 family members of the older adults living either in an aged care service organization or the community. The content validity was examined by five experts. A preliminary questionnaire with 69 items was then set up, and its psychometric property was assessed.

RESULTS

A final version of questionnaire with 42 items under four dimensions was constructed. The content validity index of the overall questionnaire was 0.93 and of each item ranged 0.80-1.00. The factor loading of all items was higher than 0.50 as per exploratory and confirmatory factor analysis; the average variance extracted for each dimension was higher than 0.50; the composite reliability was higher than 0.90; and the absolute value of the correlation coefficient of each dimension was <0.50 and less than the square root of the average variance extracted. The Cronbach's alpha value and the split-half reliability value of the overall questionnaire were 0.93 and 0.97, respectively.

CONCLUSIONS

This questionnaire has good validity and reliability, but needs further testing in multi-centered settings.

Nursing team knowledge assessment instruments about pressure injury: integrative review

Objectives: to identify in the scientific literature how the assessment of knowledge of the nursing team about pressure injuries is conducted, which instruments are used, and their psychometric properties. Methods: integrative review conducted with 44 scientific articles. The search was conducted between October and December 2021 in the following data sources: BDENF, Cinahl, Lilacs, MEDLINE, Scopus, Google Scholar, and Web of Science, using the strategy in Portuguese: ("lesão por pressão" OR "úlcera por pressão" OR "úlcera de decúbito" OR "escara de decúbito") AND enfermagem AND conhecimento, and, in English, ("pressure ulcer" OR "bed sore" OR "bed sores" OR bedsore OR bedsores) AND nursing AND knowledge. Articles published between 2012 and November 2021 were included, with text available in full, in open access, in English, Portuguese, or Spanish, resulting from original research related to care in the hospital area. Results: The most used knowledge assessment instrument was the P-PUKT and its versions, used in 50% of the studies, followed by the PUKAT and its versions. Three studies also used instruments constructed and validated by the authors, five qualitative studies, and four studies used non-validated instruments. Conclusion: Valid instruments to assess knowledge are essential to identify possible failures in patient care. Heterogeneity in the samples and in the classification criteria of the participants' level of knowledge made it impossible to compare the results obtained in the studies, constituting a limitation.

Knowledge, attitude, and practice of Iranian nurses towards pressure ulcer prevention: A systematic review

INTRODUCTION

Pressure ulcer (PU), as a long-term disabling condition, is an important indicator for patient safety and quality of nursing care in hospitals. This systematic review aimed to evaluate the knowledge, attitude, and practice of Iranian nurses towards PU prevention.

METHODS

A systematic search was conducted on PubMed, Web of Science, Scopus databases, Google Scholar Search Engine, as well as Magiran, Iranmedex, and Scientific Information Database (SID) Persian databases using the relevant keywords, from the earliest date available to August 21, 2020. Studies were appraised using the appraisal tool for cross-sectional studies (AXIS tool).

FINDINGS

Among a total of 1,543 Iranian nurses included in the 9 studies, 80.53% were female with a mean age of 31.14 (SD = 5.52) years. The mean work experience of the participants was 7.94 years (SD = 5.44). The knowledge and practice of Iranian nurses toward PU prevention were insufficient and relatively desirable, respectively. Also, the present study showed that nurses' attitudes toward PU prevention were contradictory. Age, gender, level of education, work experience, and participation in previous educational workshops were possible factors related to nurses' knowledge about PU prevention. Women with higher work experience had a more positive attitude.

CONCLUSION

This review found inappropriate knowledge, attitude, and practice of Iranian nurses toward PU prevention and highlights the importance of regular upgrading of nurses' knowledge and practice related to PU prevention.

Sexual and reproductive health knowledge, sexual attitudes, and sexual behaviour of university students: Findings of a Beijing-Based Survey in 2010-2011

BACKGROUND

Although several studies have attempted investigating sex-related knowledge, attitudes, and practices among young people in China, deeper insights were still needed to further understand how this population could be supported to make healthy and safe sexual choices. Against this background, this study used a large set of secondary data to examine associations among sexual and reproductive health (SRH) knowledge, sexual attitudes, and sexual behaviour.

METHODS

A cross-sectional study was employed to explore the associations among SRH knowledge, sexual attitudes, and sexual behaviour with a publicly available survey data among the 1196 university students from freshmen to Ph.D. candidates. Descriptive analysis was used to describe the sociodemographic characteristics of the university students by gender. Associations of sociodemographic factors with sources and categories of SRH knowledge, categories of contraceptive knowledge, sexual attitudes, and sexual behavior were explored with Poisson regressions and logistic regressions, respectively. The mediating effects of sociodemographic factors on the associations between SRH knowledge and sexual behavior, observed sexual attitudes on the associations of SRH knowledge with sexual behavior, and latent sexual attitudes on the relationship between SRH knowledge and sexual behavior were analyzed in order.

RESULTS

Descriptive analysis showed that the sample was dominated by age group (18 to 24 years), undergraduates, females, limited contraceptive knowledge, unfavorable sexual attitudes, and insufficient knowledge sources. Regression analyses showed that sociodemographic factors had significant associations with SRH knowledge, sexual attitudes, and sexual behavior. Subsequently, the mediating effects of sociodemographic factors on the associations of SRH knowledge and sexual attitudes with sexual behavior were confirmed. Controlling for sociodemographic factors, the effects of sexual attitudes on the associations between SRH knowledge and sexual behaviour could be verified. Structural equation modeling indicated that the linear sequence of sources and categories of SRH knowledge → sexual attitudes → sexual behaviour model and the triangle mediating effects of sexual behaviour → sexual attitudes → SRH knowledge model existed.

CONCLUSIONS

Sociodemographic factors and observed sexual attitudes mediated the associations between SRH knowledge and sexual behaviour. The sequence relationship: sources and categories of SRH knowledge → sexual attitudes → sexual behavior and the mediating relationship: sexual behavior → sexual attitude → sources and categories of SRH knowledge & sexual behavior → sources and categories of SRH knowledge and sexual behavior → sexual attitude → categories of contraceptive knowledge & sexual behavior → categories of contraceptive knowledge were confirmed in the sample. This study also identified an urgent need for the university students to access to SRH comprehensive knowledge.

Intensive Care Nurses' Knowledge, Attitude, and Practice of Pressure Injury Prevention in China: A Cross-Sectional Study

Background

Pressure injury (PI) remains a critical health issue worldwide. The global incidence of hospital-acquired PI is 8.4%, and among intensive-care unit (ICU) patients, it is even higher, ranging from 6.60% to 36.80%. It is important to investigate ICU nurses’ PI prevention knowledge, attitudes, and practices (KAP).

Aim

The aim of this study was to describe the level of Chinese ICU nurses’ knowledge, attitudes, and self-reported practices of PI prevention.

Materials and Methods

From March 31 to April 30, 2019, we recruited a total of 510 ICU nurses into the current study using convenience sampling. The Modified Pressure Ulcer Knowledge Assessment Tool version 2.0, Attitudes toward Pressure Ulcer Prevention instrument, and Questionnaire to evaluate nurses’ Adherence to Recommendations for Preventing Pressure Ulcers were used for data collection. We used one-way analysis of variance, Student’s t-test, and the Mann–Whitney U-test to assess differences in knowledge, attitudes, and self-reported practices of PI prevention among ICU nurses, whom we categorized by their demographic characteristics.

Results

Mean scores of participants’ knowledge, attitude, and their self-report practice were 65.82 ± 9.29, 76.65 ± 8.62, and 83.35 ± 13.55, respectively. Participants with bachelor’s degrees or higher, who worked in tertiary hospitals, and who had received training on PI prevention over the last year had higher scored on PI prevention knowledge (all P < 0.05). Participants who had received training on PI prevention over the last year scored higher on attitude than those who had not received such training over the last year (P = 0.001).

Conclusion

ICU nurses surveyed in this study did not demonstrate an acceptable level of knowledge about PI prevention, while their attitudes and self-reported practices were acceptable. Continuing education or in-service training should be provided to enhance ICU nurses’ knowledge of PI prevention.

Attitudes of nursing staff towards pressure ulcer prevention in primary and specialised health care: A correlational cross-sectional study

The aim of this correlational, cross‐sectional study was to assess the pressure ulcer prevention attitudes of the nursing staff and to identify factors associated with it both in primary and special health care. The study was conducted with nursing staff (N = 554) working in primary and special health care units in two hospital districts in Finlandin 2018 to 2019. Attitude towards Pressure ulcer Prevention instrument was used for data collection. Demographic data, Pressure Ulcer Prevention Knowledge test, and Pressure Ulcer Prevention Practice instrument were used as background variables. Data were analysed with statistical tests. Nursing staff working in primary care (n = 327) had more positive attitudes towards pressure ulcer prevention than those in specialised care (n = 209; P = .047). Working as a wound care nurse (P = .0005), working experience after graduation (P = .0017), self‐reported pressure ulcer prevention and early detection skills (P < .0001), pressure ulcer prevention knowledge (P = .0002), and views about the realisation of their unit's pressure ulcer prevention practices (P < .0001) independently explained variation in participants' attitudes. Attention should be placed on the pressure ulcer prevention attitudes of nurses who are less experienced or less skilled and who have lower pressure ulcer prevention knowledge. Positive organisational culture towards evidence‐based pressure ulcer prevention practices should be promoted.

Knowledge, attitude, and practice of nurses in intensive care unit on preventing medical device-related pressure injury: A cross-sectional study in western China

The knowledge, attitude, and practice of nurses in intensive care units (ICUs) are determinants for the efficacy of preventing the medical device-related pressure injury (MDRPI). The aim of this study was to determine the level and factors of knowledge, attitude, and practice of nurses' ICUs on preventing medical MDRPI in western China. An annual cross-sectional study was conducted in hospitals of western China from May 2020 to September 2020. Nurses' knowledge and attitudes were assessed using Clinical Nurses Prevention MDRPI of Critically Ill Patients for the Knowledge, Attitude, Practice Assessment Scale. SPSS software version 25.0 and independent t-test, Chi-square, Fisher exact, one-way analysis of variance, and multiple linear regression tests were used for data analysis. A total of 1002 nurses in ICUs from 37 hospitals in Gansu Province, China, participated in this study. The scores of overall KAP, knowledge, attitudes, and practice were 149.17 ± 24.62, 53.83 ± 12.23, 37.24 ± 6.35 and 58.10 ± 9.83, respectively. There was a positive and significant relationship between three variables. Findings revealed that nurses' knowledge score in the Tertiary hospital was higher than scores of other hospitals as 3.840 units. Moreover, the knowledge score and practice score of nurses with bachelor's degree or above were higher than other nurses and are 0.978 and 1.106 units, respectively. Based on the findings, practice of nurses increased by 0.992 units, with a 1-year increase in work experience of nurses in the ICU. The levels of knowledge, attitude, and practice of nurse in ICUs on preventing MDRPI were acceptable. The findings of the study highlight that a comprehensive approach should be conducted for raising the level of knowledge, attitude, and practice of nurses' ICUs on preventing medical MDRPI, as well as improving the quality of care for critically ill patients.

Frequency and risk factors of pressure injuries in clinical settings of affiliated to Tabriz University of Medical Sciences

AIM

Pressure injuries are considered a common and costly problem in the care of patients. Prevention and identification of risk factors for pressure injuries are very important due to the high cost of treatment and the adverse consequences of pressure injuries. This study aimed to assess the prevalence of pressure injuries and its risk factors in clinical settings of affiliated to Tabriz University of Medical Sciences.

DESIGN

A descriptive-analytical study.

METHODS

This study was performed on 200 patients who were selected by random sampling. The data collection tool was a 3-part questionnaire. Data were analysed using a t test, chi-square, Fisher's exact test and logistic regression in SPSS v. 24.

RESULTS

The mean age of the participants was 51.93 (SD 14.99) years. The rate of pressure injuries in this study was 19.5%. The most susceptible area for pressure injuries were sacral (35.89%) and gluteal (20.51%), respectively. The pressure injuries was significantly associated with Braden's criteria, age, disease diagnosis and length of hospital stay (p < .05). But there was no statistically significant difference between sex and incidence of pressure injuries (p > .05).

The development and testing of the C/WoundComp instrument for assessing chronic wound-care competence in student nurses and podiatrists

The purpose of this study was to describe the level of chronic wound-care competence among graduating student nurses and student podiatrists in comparison with that of professionals and to develop and test a new instrument (the C/WoundComp) that assesses both theoretical and practical competence in chronic wound care as well as attitudes towards wound care. The data (N = 135) were collected in 2019 from four groups (1): graduating student nurses (n = 44) (2); graduating student podiatrists (n = 28) (3); registered nurses (n = 54); and (4) podiatrists (n = 9). The data were analysed using statistical analysis. According to the results, the students' total mean competence score was 62%. Their mean score for theoretical competence was 67%, and for practical competence, it was 52%. The students' competence level was statistically significantly lower than that of the professionals (P < .0001), but the students showed a positive attitude towards chronic wound care. The instrument demonstrated preliminary validity and reliability, but this warrants further testing. This study provides new knowledge about student nurses' and student podiatrists' competence in chronic wound care, suggesting that their theoretical and practical competence is limited. In addition, it provides information on different methods of assessing competence and how they can be combined.

Prevención de lesiones por presión: conocimientos y actitudes del personal de enfermería

OBJECTIVE

Identify, analyse and summarise the empirical evidence on nurses' knowledge and attitudes towards pressure ulcer (PU) prevention.

METHOD

A systematic literature review on articles published between 2008 y 2019 was performed following PRISMA guidelines. Databases were checked for the following terms in Spanish, English and Portuguese: attitude, knowledge, pressure ulcer, and nursing staff.

RESULTS

A total of 33 articles with a quantitative descriptive approach were included in this review. The authors found a lack of knowledge on PU prevention among nursing staff. The nurses' attitudes were considered positive. Few studies examined the correlation between knowledge, attitude and clinical practice.

CONCLUSION

There is a need for continued professional education in terms of PU prevention among nurses. Research on alternative ways to organise nursing staff's work is needed. Studying up-to-date guidelines on PU prevention on a regular basis and attending training in this subject might be beneficial to improve nurses' knowledge and attitudes towards PU prevention.

Prevención de lesiones por presión: conocimientos y actitudes del personal de enfermería

OBJECTIVE

Identify, analyse and summarise the empirical evidence on nurses' knowledge and attitudes towards pressure ulcer (PU) prevention.

METHOD

A systematic literature review on articles published between 2008 y 2019 was performed following PRISMA guidelines. Databases were checked for the following terms in Spanish, English and Portuguese: attitude, knowledge, pressure ulcer, and nursing staff.

RESULTS

A total of 33 articles with a quantitative descriptive approach were included in this review. The authors found a lack of knowledge on PU prevention among nursing staff. The nurses' attitudes were considered positive. Few studies examined the correlation between knowledge, attitude and clinical practice.

CONCLUSION

There is a need for continued professional education in terms of PU prevention among nurses. Research on alternative ways to organise nursing staff's work is needed. Studying up-to-date guidelines on PU prevention on a regular basis and attending training in this subject might be beneficial to improve nurses' knowledge and attitudes towards PU prevention.

Nurses' knowledge, attitudes, and behaviours related to pressure injury prevention: A large-scale cross-sectional survey in mainland China

AIMS AND OBJECTIVES

To determine the level of and factors in nurses' knowledge, attitudes and behaviours towards pressure injury (PI) prevention.

BACKGROUND

Although there has been a declining trend in global PI prevalence and hospital-acquired rates in recent years, this has not been the case in China. Evidence in the literature indicates the importance of nurses' knowledge, attitudes and behaviours for promoting PI prevention.

DESIGN

Cross-sectional study.

METHODS

A total of 1,806 nurses from 10 tertiary general hospitals in Hunan Province, China, participated in this study. Nurses' knowledge and attitudes were assessed using Pieper's Pressure Ulcer Knowledge Test and Attitude towards Pressure Ulcer Prevention Instrument, respectively, and behaviours were measured using a researcher self-designed questionnaire. Multiple logistic regression analysis determined factors affecting the nurses' PI-prevention knowledge, attitudes and behaviours. A STROBE checklist was used to report findings.

RESULTS

Among all nurses involved in this study, 41.7% had insufficient PI-prevention knowledge, 46.6% had negative PI-prevention attitudes, and 21.8% had poor PI-prevention behaviour. Nurses with a bachelor's degree or above were more likely to have adequate PI-prevention knowledge. Increased PI-prevention training frequency increased the nurses' positive attitude scores for PI prevention; longer years of service and a higher number of PI-prevention trainings attended predicted better PI-prevention behaviours.

CONCLUSION

Chinese nurses' PI-prevention knowledge and attitudes in this study were unsatisfactory, while their PI-prevention behaviour was acceptable. Increasing PI-prevention training frequency can help improve Chinese nurses' PI-prevention attitudes and further behaviour. Having a minimum of a bachelor degree may be beneficial to Chinese nurses' PI-prevention knowledge, but more evidence is needed.

RELEVANCE TO CLINICAL PRACTICE

Chinese nurses have insufficient knowledge about PI-repositioning, inadequate practices in PI nutrition assessment, and low confidence in their personal competence regarding PI-prevention. The key solution for the above issues is to promote ongoing education and training based on strong clinical leadership.