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

Abstract

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.

Effectiveness of an Interventional Program on Nursing Staff’ Knowledge Concerning Prevention of Pressure Ulcer at the Intensive Care Unit in Al-Diwaniyah Teaching Hospital

“…The results in the (Table 4.3) revealed that there is a significant association between the levels of education with nursing staffs' knowledge in the study sample related to main domain toward prevention of PU at post-test. This finding could be supported through study conducted by (29) in China; the researcher reported that the highest educational group (bachelor or higher) was found to have an association of significance with regard to their knowledge, which concordant with the current study.…”

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

“…The present study revealed that 33.1% of participants had not received training on PI prevention over the last year, which might have been due to nurses' heavy workloads and lack of time to participate in training programs. Nursing managers should take note of this issue and establish strategies to increase ICU nurses' participation in PI training programs so as to improve their PI prevention 31 This large discrepancy might be due to the different questionnaires and cutoff scores between that study and the current one. The earlier study applied the Pressure Ulcer Knowledge Test (PUKT).…”

“…34 In this study, we translated total scores into percentage scores and set mean cutoff score at 80/100 to reflect sufficient knowledge of PI prevention on the part of the ICU nurse, in accordance with a similar study conducted among Chinese general nurses. 31 Participants' PI prevention attitude was measured by the Attitude toward Pressure Ulcer Prevention Instrument (APuP), developed and validated by Beeckman et al 35 The instrument consists of 13 items covering five themes:…”

“…Again, we translated total scores into percentage scores, and for this questionnaire we selected a mean cutoff score of 80 to reflect the nurse's good performance on PI prevention practice, based on a previous study in China. 31 The data collection instrument had four parts: demographic information, and then three questionnaires that measured PI prevention knowledge, PI prevention attitude, and PI prevention practice. We collected participants' demographic information using a researcher-developed questionnaire that covered age, gender, highest educational level, types of hospitals worked in, years of work in ICUs, Before collecting data, we obtained permission to use, translate, and modify the PUKAT 2.0, APuP, and QARPPU from their respective authors, as well as permission to use the Chinese version of APuP from the relevant Chinese scholars.…”

“…28 To the best of our knowledge, ICU nurses' KAP of PI prevention has not been elucidated in China. [29][30][31] An assessment of the same is critically needed among ICU nurses specifically, considering that PIs are most prevalent in the ICU setting and have detrimental effects on patients. Therefore, the present study examined this topic with the aim of providing nursing administrators with baseline data with which to develop training programs to increase ICU nurses' PI prevention KAP, thereby improving the quality of PI prevention.…”