How does the training given to intensive care nurses affect their attitudes toward preventing pressure ulcers?

OBJECTIVE

The study aimed to determine the effect of training in the prevention/treatment of pressure ulcers on nurses' attitudes.

MATERIAL METHOD

The study was conducted experimentally in a pretest-posttest design. Training was given to nurses participating in the study with content prepared by "Wound and Ostomy Incontinence Nurses Association" guide. The study was conducted between August and October with nurses working in Level 3 intensive care units. The study was completed with 79 nurses. Before the training was given, the "Nurse Introduction Form" and " Attitude Towards Pressure Ulcer Prevention Instrument (ATPUPI)" form were applied to those. All nurses were re-administered the ATPUPI scale three months after the training to evaluate their attitudes. Frequency analysis, descriptive statistics, one-way ANOVA, and independent sample tests were used in statistical analyses.

RESULTS

The mean age of the nurses was 29.62 ± 5.74 years, the mean length of service was 71.77 ± 77.19 months, 94.9 % were graduates, and 82.3 % worked in shifts. The mean scores before the training were 44.53 ± 4.13 and 45.12 ± 2.53 after the training. It was determined that there was a significant difference between the nurses who did not receive training on pressure ulcers other than undergraduate education and those who obtained training in terms of the mean score of ATPUPI. Still, after the training, the mean scores reached a similar level, and this difference disappeared. The increase in the mean scores of those who did not receive any education other than undergraduate education was found to be statistically significant.

CONCLUSION

As a result of our study, intensive care nurses' attitudes toward preventing pressure ulcers were found to be at a high level. It was found that the training given to nurses who had not received training on pressure ulcers other than undergraduate education had a significant positive effect on their attitudes. According to this result, it is recommended that in-service training should be given from the moment they start intensive care and repeated at regular intervals to ensure continuity in knowledge, attitude, and care behavior.

Nursing students' knowledge, attitudes and learning occasions about pressure injuries at the time of graduation: A multi-method pre-post pandemic study

INTRODUCTION

Pressure injuries (PIs) are a significant issue in healthcare system: nursing students are recommended to be prepared to assess the risk, prevent and manage them. However, despite the coronavirus disease-2019 (COVID-19) pandemic significantly affected nursing students' learning opportunities no data regarding their impact of PIs knowledge, attitudes and learning occasions have been documented to date.

AIMS

To describe the post-pandemic knowledge and attitudes regarding PI prevention and management and to compare clinical learning opportunities in the field of PIs before and after the COVID-19 pandemic.

METHOD

A descriptive multi-method study involving students at the time of their graduation in the before (n = 114) and after the pandemic (n = 113). The Italian versions of the Pressure Ulcer Knowledge Assessment Tool (PUKAT-IT) and Attitude Toward Pressure Ulcer Prevention (APuP-IT) scales were used. Data regarding pre- and post-pandemic learning opportunities were retrospectively collected from the Student Portfolio of Skills.

RESULTS

The average PUKAT-IT score was 57.92 % (cut-off 60 %), which indicates insufficient knowledge; the average APuP-IT score was 78.19 % (cut-off 75 %), which shows positive attitudes towards PI. Comparing the pre- and the post-pandemic groups, learning opportunities in PI risk assessment and prevention significantly decreased (overall 38.90 vs 32.27 and 35.26 vs 25.97, respectively) while those regarding the PI management remained stable.

CONCLUSION

In the post-pandemic times, nursing students' knowledge about PIs remains insufficient while their attitudes are adequate; the pandemic significantly reduced students' exposure to prevention and assessment learning opportunities during their internship, which suggests a need to update educational strategies to ensure appropriate knowledge and learning experiences in this field.

Evaluation of final-year nursing students' attitudes towards preventing medical device-related pressure ulcers using a ABC model of affect, behavior and cognitive dimensions

INTRODUCTION

Half of the hospital-acquired pressure ulcers are associated with the use of medical devices. Nursing students provide care services to patients in clinical settings and intensive care units who have or are at risk for medical device-related pressure ulcers (MDRPUs). In the prevention and care of MDRPUs, the attitudes of nursing students towards preventing of pressure ulcers are as crucial as their knowledge level and clinical skills.

AIM

The aim of this descriptive study is to assess the attitudes of final-year nursing undergraduate students towards preventing MDRPUs across cognitive, affective, and behavioral dimensions of ABC model.

MATERIALS AND METHODS

Data of the study was handed between April 1 and December 31, 2021, with 147 final-year nursing students. Data were collected using the Student Information Form and the Attitude Towards Preventing Medical Device-Related Pressure Ulcers Questionnaire (ATP-MDRPUsQ).

RESULTS

The mean attitude score towards preventing MDRPUs was 3.98 ± 0.45 on a 5-point Likert scale. The mean scores for the cognitive, affective, and behavioral sub-dimensions were 3.88 ± 0.57, 4.15 ± 0.51, and 4.00 ± 0.672, respectively. A moderate positive relationship was found between the cognitive sub-dimension and both the affective and behavioral sub-dimensions (r = 0.451; r = 0.302; p < 0.01, respectively). Based on cluster analysis, the mean attitude scores of students towards MDRPU prevention were grouped into two clusters. The students in Cluster-2 and female students had higher mean attitude scores (p < 0.01). The item with the lowest mean score in the questionnaire pertained to the item, "I believe that I need training on the etiology and prevention of medical device-related pressure ulcers."

CONCLUSION

The general attitudes of final-year nursing students towards prevention MDRPU were satisfactory. However, their cognitive attitudes were less positive compared to their affective and behavioral attitudes. It is recommended to incorporate theoretical and practical courses focusing on the prevention of these injuries into nursing curricula to enhance students' knowledge and attitudes.

Knowledge and Attitudes Toward Pressure Ulcer Prevention Evidence-based Guidelines among Nursing Students at Jazan University, Saudi Arabia

BACKGROUND

Pressure ulcers (PUs) are a common global problem. They affect health-care costs and patient health because of increased morbidity and mortality rates. Critically ill patients are more prone to acquiring PUs than other patients. As the prevalence of PUs is high in Saudi Arabia, more attention is required for PU prevention. Nurses' knowledge and attitudes toward PU prevention are crucial.

AIMS

This study aimed to assess the knowledge and attitudes of nursing students regarding PU prevention evidence-based guidelines.

SETTING AND DESIGN

This descriptive, cross-sectional study was conducted among nursing students at Jazan University.

MATERIALS AND METHODS

Data were collected using an electronic questionnaire.

STATISTICAL ANALYSIS USED

Data were entered, coded, and analyzed using the SPSS version 23.

RESULTS

A total of 378 participants were included. The mean age was 22.4 ± 3.4 years, and the mean knowledge score was 7.6 ± 2.64 (range = 0-16). Of the participants, 365 (96.6%) and 13 (3.4%) were considered to have poor and good knowledge about PUs, respectively. Only 72 (19%) correctly identified a lack of oxygen as the cause of PUs; other participants answered malnutrition and moisture. Conversely, 200 (52.9%) participants indicated that recent weight loss below patients' ideal weight increases the risk for PUs. Concerning knowledge about preventive measures, 64 (16.9%) participants correctly answered that a backward sitting position, with both legs resting on a footrest, can reduce the amount of pressure. Meanwhile, 169 (44.7%) participants correctly selected thick air cushion as a means to reduce the magnitude of pressure when patients are sliding down on a chair. Some participants answered that PUs can be reduced if patients are mobilized. Seventy-two (19%) participants indicated that patients laying on a visco-elastic foam mattress should be repositioned every 2 h to reduce the duration of pressure. Age, year of education, training experience, and department were not significantly associated with knowledge about PUs (P = 0.333, P = 0.370, P = 0.700, and P = 0.810, respectively).

CONCLUSIONS

The general knowledge and attitudes toward PUs of the nursing students at Jazan University were poor. Nevertheless, they had an average knowledge level regarding PU prevention. Age and training experience were not significantly associated with knowledge about PUs.

Exploring the relationship between pressure ulcer knowledge and self-efficiency among nursing students: A multicenter study

AIM

To determine the relationship between the knowledge and self-efficiency regarding pressure ulcers of nursing students.

METHODS

This descriptive and correlational study was conducted with 775 nursing students from three different universities in various regions of Turkey. The "Pressure Ulcer Knowledge Assessment Tool-Updated Version" and "Pressure Ulcer Management Self-Efficiency Scale for Nurses" tool were used to collect data between May and September 2023. The Strengthening the Reporting of Observational Studies checklist was followed to report this study.

RESULTS

The mean knowledge score was 7.27 ± 3.09, and the mean self-efficiency on pressure ulcer management score was 35.5 ± 18.3. A statistically significant positive correlation was found between nursing students' knowledge and self-efficiency mean scores regarding pressure ulcers (p < 0.05). A significant difference was also found between the students' academic levels and gender and their knowledge and self-efficiency scores regarding pressure ulcers.

CONCLUSION

In this study, where the data covers these three institutions, students' pressure ulcer knowledge and self-efficiency scores were lower compared to all academic years. Accordingly, it was also determined that students with more nursing practice experience showed higher knowledge and self-efficacy scores than students with less nursing practice experience. Additionally, the students' self-efficacy increased along with their knowledge level. Training courses may be suggested to improve students' knowledge and self-efficiency regarding pressure ulcers.

Effects of Web-Assisted Education on Nursing Students' Pressure Injury Knowledge Levels

OBJECTIVE

To investigate the effect of web-assisted education on the pressure injury knowledge levels of nursing students.

METHODS

The study was conducted with 106 first-year students in the Nursing Department. Those who received both web-assisted education and conventional education were assigned to the experimental group, and those who received only conventional education were assigned to the control group. The authors used arithmetic mean, percentages, Student t test, and χ2 test to analyze the data.

RESULTS

The rate of the correct responses given to the questions by the students was 97.55% in the experimental group and 85.15% in the control group. The comparison of the mean number of correct answers revealed a statistically significant difference between the two groups.

CONCLUSIONS

The authors conclude that the web-supported education given to nursing students in addition to the conventional education positively contributed to their learning level.

Pressure Injury Knowledge and Attitudes of Senior Nursing Students

OBJECTIVE

To describe the pressure injury (PI) knowledge and attitudes of senior nursing students (SNSs).

METHODS

This study used a descriptive and cross-sectional design. The study population consisted of SNSs involved in a nursing program in the Aegean region of Turkey. The authors collected data using a student information form, the Turkish version of the Attitude towards Pressure Ulcer Prevention instrument, and the Turkish version of the Pressure Ulcer Prevention Knowledge Assessment Instrument.

RESULTS

One hundred seventy SNSs were included; 50% had experience preventing PI, 14.1% had provided care to patients with PIs, and 21.2% had staged PIs. The SNSs' average PI prevention knowledge score was 13.06 ± 2.94 (50.3% correct), and only 20.5% (n = 35) of the SNSs answered questions at an acceptable proficiency level (60%). The mean Attitude towards Pressure Ulcer Prevention score of the SNSs was 39.38 ± 2.73 (75.7% correct).

CONCLUSIONS

The results of the research indicated that the SNSs' knowledge about preventing PI was insufficient, although their attitudes toward PI prevention were positive. Because adequate training on PI is important for patient care, students' knowledge deficiencies regarding PIs should be identified and addressed.

Nursing Students' Knowledge on Pressure Injuries Following a Blended-Learning Unit: A Quasi-experimental Study

OBJECTIVE

To assess first-year bachelor's degree in nursing students' knowledge about pressure injury (PI) etiology, classification, prevention, and management following blended learning and clinical practice.

METHODS

A quasi-experimental design was used. Nursing students' PI knowledge was measured using the French version of the Pressure Ulcer Knowledge Assessment Tool (PUKAT) at three time points: baseline (before a blended-learning unit, consisting of 2 hours of e-learning and 3 hours of practical workshop), after the blended-learning unit, and after clinical practice.

RESULTS

A total of 21 students participated over the three time points. At baseline, the mean percentage of correct answers on the PUKAT was 45.8%. This score increased to 59.2% following the blended-learning unit and 65% after completing the clinical practice (F2,58 = 19.08; P = .00). Over the three time points, students scored highest on knowledge of risk assessment and lowest on knowledge of prevention.

CONCLUSIONS

Blended-learning units combining e-learning and practical workshops are valuable tools to increase students' knowledge about PIs. The PUKAT enables the evaluation of changes in students' knowledge following a teaching unit on PIs. However, more research is needed to assess the long-term evolution of knowledge and the impact of this teaching on clinical practice.

A systematic review of nursing students' attitude and related factors towards pressure ulcer prevention

The purpose of this review study is to investigate the attitude of nursing students toward the prevention of pressure ulcers (PUs) and related factors. From February 1, 2023, a comprehensive search was conducted in international and Persian electronic databases such as Web of Science, PubMed, Scopus, Iranmedex, and Scientific information database (SID). The keywords obtained from Medical Subject Headings, including "Attitude", "Nursing students", and "Pressure ulcer" were used in this search. The quality assessment of the present studies in this systematic review was based on the appraisal tool for cross-sectional studies (AXIS tool). A total of 6454 nursing students participated in ten cross-sectional studies. All students were studying at the undergraduate level and 81.20% of them were female. Nursing students were in the first (39.27%), second (28.19%), and third and fourth (32.54%) academic years. Among the participants, 49.86% have completed at least 2 clinical units. The mean scores of attitudes toward PU prevention in nursing students based on attitude toward PU prevention (APuP) and researcher-made questionnaires were 75.01% and 68.82%, respectively. The attitude of nursing students was influenced by various factors, including age, sex, academic year, clinical experience, number of clinical units, experience in caring for PU patients, previous courses on PU in the curriculum, and contribution of training to knowledge. Also, in the present study, the positive relationship between the attitude and knowledge of nursing students was shown as the only significant correlation. In sum, the attitude of the majority of nursing students toward the prevention of PUs was at a satisfactory level. Therefore, it is expected to transfer the necessary knowledge to them with proper planning so that preventive actions can be carried out by following the guidelines.

The effect of knowledge levels of intensive care nurses about pressure injuries on their attitude toward preventing pressure injuries

AIM

The aim of this study was to determine the current knowledge levels of intensive care nurses about pressure injuries and their attitudes toward preventing pressure injuries, and to reveal the relationship between these variables.

MATERIALS AND METHODS

This descriptive cross-sectional study was conducted with 152 nurses, working in the Adult Intensive Care Units of a Training and Research Hospital. Data were collected between 10.08.2021 and 31.11.2021 with the Patient Information Form, Modified Pieper Pressure Ulcer Knowledge Test and Attitude toward Pressure Injury Prevention Scale. Frequency analysis, descriptive statistics, multiple logistic regression analysis and the structural equation modeling technique were used in the analysis of the study data.

RESULTS

The mean age of the nurses was 25.82 ± 3.42 years, 86.2% of them were female and 67.1% of them had a bachelor's degree. Total mean score of the Modified Pieper Pressure Ulcer Knowledge Test of the intensive care nurses was found to be 32.58 ± 6.58. The knowledge score of 113 out of 152 nurses was ≥60% or above. The total mean score of the Attitude toward Pressure Injury Prevention Scale was 42.00 ± 5.70 and a total of 76.97% (117 participants) of them were found to score 75% or above on the scale. The results of the regression analysis showed that educational degree, and status of having training about pressure injuries did not affect the total mean score of the Knowledge Test and the Attitude Scale. However, it revealed that the frequency of encountering a patient with pressure injuries in the unit where they work has affected the total mean score of the scales significantly (p < 0.05). As per the results of the structural equation model, the Modified Pieper Pressure Ulcer Knowledge Test scores of the nurses were found to have a statistically significant effect on the scores of the Attitude toward Pressure Injury Prevention Scale (p < 0.05).

CONCLUSION

This study revealed that intensive care unit nurses had a positive attitude toward Pressure Injury Prevention and their knowledge was sufficient and that as the Modified Pieper Pressure Ulcer Knowledge Test scores increase, their positive attitude toward Pressure Injury Prevention also increases.

Nurses' and nursing students' knowledge and attitudes to pressure injury prevention: A meta-analysis based on APUP and PUKAT

BACKGROUND

Morbidity and mortality among patients due to pressure injuries continue to rise. Nurses play a critical role in preventing pressure injuries. However, published results on nurses' knowledge and attitudes for pressure injury prevention are often contradictory.

OBJECTIVES

To conduct a meta-analysis of nurses' and nursing students' knowledge and attitudes toward pressure injury prevention.

DESIGN

A meta-analysis of cross-sectional studies.

DATA SOURCES

Ten databases were queried for the meta-analysis. The search period was from the time of the databases' establishment to February 2023.

REVIEW METHODS

This review followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The Agency for Healthcare Research and Quality (AHRQ) was used to assess the methodological quality of the included studies. Statistical analysis was conducted with the Stata 15.0 software, and the quantitative data of knowledge and attitude toward preventing PI in all studies were summarized.

RESULTS

Thirteen studies from 9 countries were included. The meta-analysis showed that nurses and nursing students had low knowledge but positive attitudes toward pressure injury prevention. Subgroup analysis showed that the pooled proportion of both knowledge and attitudes was higher in Asia than in Europe. Nurses had higher knowledge than nursing students, however, the former had a more negative attitude than the latter. Sensitivity analyses were robust. Egger's test showed no significant publication bias.

CONCLUSION

The knowledge of nurses and nursing students about pressure injury prevention is not promising and there is an urgent need for continuous learning. Attitudes are more positive but there is room for improvement. The relevant departments should strengthen nurses' and nursing students' knowledge of pressure injury prevention and further improve their attitudes toward pressure injury prevention.

Nurses' knowledge on pressure ulcer prevention: An updated systematic review and meta-analysis based on the Pressure Ulcer Knowledge Assessment Tool

Background

Pressure ulcers (PUs) are an indicator of the quality of nursing care and nurses can prevent PUs well if they have sufficient knowledge. Numerous studies in this field have reported different results. The aim of this study was to estimate the pooled score of nurses' knowledge about PU prevention based on the Pressure Ulcer Knowledge Assessment Tool (PUKAT).

Methods

In this systematic review and meta-analysis, databases including Web of Science, ScienceDirect, PubMed, and Scopus were searched. All studies published in English between 2011 and 2022 that reported the status of nurses' knowledge of PU prevention based on PUKAT were included in the analysis. Based on heterogeneity between the studies, the data were analyzed using a random effects model.

Results

The pooled scores of PU prevention knowledge in nurses and nursing students were (51.5%; 95% CI: 45.8-57.2%) and (48.9%; 95% CI: 42.5-55.2%), respectively. As the age of the participants increased, the pooled score of pressure ulcer prevention knowledge increased significantly (p = 0.028). The publication bias was not significant. The highest and lowest knowledge scores in nurses and nursing students were related to the fourth dimension (nutrition) and the fifth dimension (preventive measures to reduce the amount of pressure/shear), respectively.

Conclusion

Knowledge of nurses and nursing students about PU prevention is insufficient. Providing regular training to nurses and including the principles of PU prevention in the curriculum of nursing students to improve their knowledge seems necessary.

Pressure injury knowledge of Turkish internship nursing students

AIM

This study aimed to describe the pressure injury (PI) knowledge of Turkish internship nursing students (INSs).

MATERIALS AND METHODS

This descriptive study was performed using the Turkish version of the Modified Pieper Pressure Ulcer Knowledge Test. The study population consisted of INSs in a nursing program in the West Black Sea Region, Turkey. The sample of the study was 278 (74.1% of a total of 375 volunteer INSs).

RESULTS

The mean knowledge test score was 29.03 ± 7.15 (range 11-44). The prevention/risk score was higher; only 28.4% of the students had a satisfactory test score.

CONCLUSION

The results of this study indicated that the INSs had significant knowledge gaps regarding PI. Nursing students' knowledge deficiencies regarding PIs should be identified at undergraduate level, and the necessary educational measures should be taken.

Knowledge and attitudes of Turkish nursing students towards pressure injury prevention

AIM

Nurse educators are expected to teach nursing students the necessary knowledge and attitudes to prevent pressure injuries (Pİ) development. This study aims to assess the knowledge levels and attitudes of nursing students towards Pİ prevention and to analyze the relationship between their knowledge and attitudes.

MATERIAL AND METHODS

This study adopted a cross sectional, descriptive, and correlational research design. 259 students of the nursing department of a private university in the Turkish Republic of Northern Cyprus during the spring semester of the 2018-2019 academic year constituted the population of the study. Student information form, the Turkish version of Pİ prevention knowledge assessment instrument (PUPKAI-T), and attitude towards Pİ prevention instrument (APuP) were used for data collection. Data were analyzed by Kruskal-Wallis, Mann- Whitney U tests and Spearman's correlation. Ethics committee approval was received.

RESULTS

Mean PUPKAI-T score was 10.16 ± 2.44 (range: ≥ 16). Participants obtained the lowest score from the etiology and causes (32.3%) and classification and observation (33.5%) subscales of the PUPKAI-T. The mean score obtained by the participants from the APuP was 44.62 ± 3.54 (range; min; 13, max; 52). We found a positive, weak, and statistically significant correlation between the PUPKAI-T and the APuP scores (r = 0.131, p = 0.034).

CONCLUSION

The study found that the mean PUPKAI-T scores of the nursing students were low and their APuP scores indicated a positive attitude. The findings imply that the nursing curriculum might be revised and new courses might be introduced to increase the knowledge levels of nursing students on Pİ prevention.

Validation of the Pressure Injury Prevention Knowledge questionnaire in nursing students: Rasch analysis

OBJECTIVE

The aim of our study is to measure the knowledge of nursing students at the University of Jaén about evidence-based recommendation for the prevention of pressure injuries.

METHOD

A cross-sectional observational and validation study was carried in 2019, using an online survey. All the students registered on the Nursing Degree programme of the University of Jaén were invited to participate. The psychometric properties of the Pressure Injury Prevention Knowledge questionnaire (PIPK) were tested by a Rasch analysis. With the analysis, the percentage of correct and wrong answers was calculated, the global score and the association with some educational variables.

RESULTS

The PIPK questionnaire showed adequate psychometric characteristics (alpha=.89) and good fit to the Rasch model. The average knowledge score on pressure injury prevention obtained was 21.0 (this is 67.7% of the maximum). Higher scores were obtained by the students that had finished some clinical placements; those with more placements; had attended a meeting about pressure injuries and those in a higher year of the programme.

CONCLUSIONS

The PIPK questionnaire is a valid and reliable instrument for measuring the knowledge of nursing students about pressure injuries prevention. The nursing students of the University of Jaén obtained a score in the questionnaire higher than 50%.

A systematic and psychometric review of tests measuring nurses' wound care knowledge

Wound care is an important realm of nurses' clinical responsibilities, and a broad knowledge and range of skills are needed to perform efficient and safe patient care. Nurses' knowledge on this matter can be measured using knowledge tests. This study aims to identify, define, and analyse the knowledge tests developed for the measurement of nurses' wound care knowledge, and to evaluate the psychometric properties of the tests. This study was a systematic literature review. A total of 52 studies and 18 instruments were found. Of the 18 instruments, only 5 had been used more than once and were successful in a psychometric evaluation. These five instruments were analysed on the basis of their psychometric properties by using Zwakhalen et al.'s (2006) psychometric testing framework. According to the analysis, the Pressure Ulcer Knowledge Test (PUKT) and the Pressure Ulcer Knowledge Assessment Tool (PUKAT) were the most valid and reliable instruments for measuring nurses' wound care knowledge. Most of the instruments identified and analysed focused on pressure ulcers, indicating that future instruments could focus more on other types of wounds or on wound care in general in order to receive a broader understanding of nurses' wound care knowledge.

Graduating student nurses' and student podiatrists' wound care competence: a cross-sectional study

OBJECTIVE

To explore and describe graduating student nurses' (SNs) and student podiatrists' (SPs) theoretical wound care competence, as well as students' own perceptions of their wound care competence and their opinions about the received wound care education.

METHOD

A descriptive cross-sectional design was used. Data were collected from five Finnish universities using a graduating SNs and SPs wound care competence (WCC) questionnaire, which included a wound care knowledge test and a wound care competence self-evaluation. Data were analysed statistically and with qualitative content analysis.

RESULTS

A total of 213 students (response rate: 86%) participated in the study. Of these, 194 were SNs and 19 SPs. Students answered 48% of the knowledge test questions correctly (SNs 46%, total score 14/29; SPs 60%, total score 13/22). SPs' wound care competence was statistically significantly higher (p<0.0001) than that of SNs. Both groups self-evaluated their wound care competence to be deficient. Students who had more practical training in wound care during practical training periods scored statistically significantly better in the knowledge test. Students showed a positive attitude towards wound care by expressing an interest in it and acknowledging its importance.

CONCLUSION

Graduating SNs' and SPs' theoretical wound care competence is limited. The results showed that more wound care education, especially practical training, is needed in SNs' and SPs' education curriculums to adequately respond to the increasing needs in wound care.

Design and psychometric testing of the attitude towards the prevention of incontinence-associated dermatitis instrument (APrIAD)

Despite the availability of a range of skin care products for the prevention of incontinence-associated dermatitis (IAD), prevalence remains high. Nurses' attitude is an important determinant to take into account in quality improvement projects. This study aimed to design a psychometrically test the attitude towards the prevention of incontinence-associated dermatitis instrument (APrIAD). A prospective psychometric instrument validation study was performed in a convenience sample of 217 Belgian nurses. Construct validity and reliability (internal consistency, stability) were tested. The exploratory factor analysis demonstrated a model consisting of four factors and 14 items: (a) beliefs about the impact of IAD on patients, (b) beliefs about team responsibility to prevent IAD, (c) beliefs about personal responsibility to prevent IAD, and (d) beliefs about the effectiveness of IAD prevention products and procedures. Cronbach's α was 0.72 for factor 1, 0.65 for factor 2, 0.63 for factor 3, and 0.47 for factor 4. The intra-class correlation coefficient was 0.689 (95% confidence interval [CI] 0.477-0.825) for the total instrument, 0.591 (95% CI 0.388-0.764) for factor 1, 0.387 (95% CI 0.080-0.626) for factor 2, 0.640 (95% CI 0.406-0.795) for factor 3, and 0.768 (95% CI 0.597-0.872) for factor 4. Psychometric testing of the APrIAD demonstrated adequate validity and reliability measures.

Nurses' knowledge on pressure injury prevention: a systematic review and meta-analysis based on the Pressure Ulcer Knowledge Assessment Tool

Introduction

Inadequate knowledge on pressure injury (PI) can have a detrimental effect on preventive care strategies. The aim of this study was to assess the overall knowledge of nurses on PI prevention based on their scores on the Pressure Ulcer Knowledge Assessment Tool (PUKAT) and its subscales in different settings.

Methods

In this systematic review and meta-analysis, databases including Web of Science, Science Direct, Google Scholar, PubMed, and Scopus were searched, using the following keywords: Pressure Ulcer, Pressure injury, Bedsore, Pressure Sore, Decubitus Ulcer, knowledge, and their possible combinations. Based on heterogeneity between the studies, the data were analyzed using a random effects model. All of the analyses were performed using STATA v.12 software.

Results

In all three groups (nurses, assistant nurses, and nursing students), the lowest knowledge scores were for prevention measures to reduce the amount of pressure/shear. Nurses' knowledge (55.4%, 95% CI: 42.4-68.4) was higher than that of nursing students (52.7%, 95% CI: 3-49.56) and assistant nurses (42.2%, 95% CI: 16.4-68).

Conclusion

The overall knowledge of nurses on PI prevention was lower than the recommended level (60%). Regular training courses and review of PI prevention guidelines can be useful in updating the knowledge of nurses, especially assistant nurses and nursing students on PI prevention.

Australian nursing students' knowledge and attitudes towards pressure injury prevention: A cross-sectional study

AIM

The aim of this study was to assess student nurses' knowledge of and attitudes towards pressure injury prevention evidence-based guidelines.

BACKGROUND

Pressure injuries are a substantial problem in many healthcare settings causing major harm to patients, and generating major economic costs for health service providers. Nurses have a crucial role in the prevention of pressure injuries across all health care settings.

DESIGN

A multi-centered, cross-sectional study was conducted using a paper-based questionnaire with undergraduate nursing students enrolled in seven universities with campuses across five Australian states (Queensland, New South Wales, Western Australia, Victoria and Tasmania).

METHODS

Data were collected from nursing students using two validated instruments (Pressure Ulcer Knowledge Assessment Instrument and Attitude Toward Pressure Ulcer Prevention Instrument), to measure students' pressure injury prevention knowledge and attitudes.

RESULTS

Students reported relatively low pressure injury prevention knowledge scores (51%), and high attitude scores (78%). Critical issues in this study were nursing students' lack of knowledge about preventative strategies to reduce the amount and duration of pressure/shear, and lower confidence in their capability to prevent pressure injury. Level of education and exposure to working in a greater number of different clinical units were significantly related to pressure injury prevention knowledge and attitude scores.

CONCLUSION

The study findings highlight the need to implement a comprehensive approach to increasing Australian nursing students' pressure injury prevention and management knowledge, as well as ensuring that these students have adequate experiences in clinical units, with a high focus on pressure injury prevention to raise their personal capability.

Graduating student nurses' and student podiatrists' wound care competence - An integrative literature review

The objective of this literature review is to describe graduating student nurses' and student podiatrists' wound care competence. This integrative literature review has been conducted with a systematic search process. Original studies were analysed by qualitative content analysis with the following stages: open coding, creating categories and abstraction. The literature search was conducted on May 2016 and reconducted on October 2016 using the Medline/Pubmed, CINAHL, Cochrane Library, Web of Science, Scopus and National Medic databases and 12 original studies were found. All the studies addressed graduating student nurses' wound care competence. According to original studies, graduating student nurses' wound care competence was inadequate. However, the students showed a positive attitude towards wound care. Subthemes of this literature review were: 1) Wound care knowledge, 2) Attitudes towards wound care, 3) Wound care preparedness and 4) Wound care education which created the main theme Graduating nurses' wound care competence. No studies were found about graduating student podiatrists' wound care competence. Graduating student nurses' wound care knowledge was deficient. Wound care education seemed to have a positive relation to students' wound care competence. The findings indicate that more information about graduating student nurses', and especially graduating podiatrists', wound care competence is needed.

[A Structural Equation Model of Pressure Ulcer Prevention Action in Clinical Nurses]

PURPOSE

The purpose of this study was to construct and test a structural equation model for pressure ulcer prevention action by clinical nurses. The Health Belief Model and the Theory of Planned Behavior were used as the basis for the study.

METHODS

A structured questionnaire was completed by 251 clinical nurses to analyze the relationships between concepts of perceived benefits, perceived barriers, attitude, subjective norm, perceived control, intention to perform action and behavior. SPSS 22.0 and AMOS 22.0 programs were used to analyze the efficiency of the hypothesized model and calculate the direct and indirect effects of factors affecting pressure ulcer prevention action among clinical nurses.

RESULTS

The model fitness statistics of the hypothetical model fitted to the recommended levels. Attitude, subjective norm and perceived control on pressure ulcer prevention action explained 64.2% for intention to perform prevention action.

CONCLUSION

The major findings of this study indicate that it is essential to recognize improvement in positive attitude for pressure ulcer prevention action and a need for systematic education programs to increase perceived control for prevention action.