Knowledge, Attitude, and Practice of Intensive Care Unit Nurses Regarding Prevention and Care of Pressure Ulcer

Farzi, Saba; Mohammadipour, Fatemeh

doi:10.22087/ijac.2024.497754.1037

Knowledge, Attitude, and Practice of Intensive Care Unit Nurses Regarding Prevention and Care of Pressure Ulcer

Document Type : Research

Authors

Saba Farzi ¹

Fatemeh Mohammadipour ²

¹ Faculty of Nursing and Midwifery , Lorestan University of Medical Sciences, Lorestan, Khorammabad, Iran

² Social Determinants of Health Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran

10.22087/ijac.2024.497754.1037

Abstract

Pressure ulcers represent a significant financial burden in healthcare, ranking as the third most costly condition following heart disease and cancer. The prevalence of pressure ulcers serves as a key indicator of the quality of healthcare and nursing services. Nurses are integral to the prevention and management of pressure ulcers; thus, this study aimed to assess the knowledge, attitudes, and practices of nurses in this area. Conducted in 2022, the study employed a descriptive methodology. A convenience sample of 200 nurses from an educational and medical center affiliated with Lorestan University of Medical Sciences was utilized. Data were collected via a four-part questionnaire and analyzed using SPSS version 16, employing both descriptive and analytical statistical methods. The mean scores for nurses' knowledge, attitudes, and practices in the prevention and management of pressure ulcers were 51.1 ± 7.5, 60.35 ± 16.53, and 50.1 ± 10.5 out of 100, respectively. The findings indicate that nurses' knowledge and practices in pressure ulcer prevention and management are at a relatively satisfactory level. Given the threat that pressure ulcers pose to patient safety, it is imperative for healthcare center managers to implement strategies to enhance the capabilities of the healthcare team, particularly nurses.

Keywords

Pressure ulcers

Knowledge

Attitude

Practice

Nurse

1. Ursavaş FE, İşeri Ö. Effects of education about prevention of pressure ulcer on knowledge and attitudes of nursing students. Journal of Tissue Viability. 2020;29(4):331-6.
2. Farzi S, Farzi S, Yousefii H, Moladoost A, Moieni M. Knowledge, Attitue and practice of nurses concerning pressure ulcer prevention and its relationship with some demographic characteristics. Iranian Journal of Nursing Research. 2016;11(4):66-71.
3. Li Z, Lin F, Thalib L, Chaboyer W. Global prevalence and incidence of pressure injuries in hospitalised adult patients: A systematic review and meta-analysis. International journal of nursing studies. 2020;105:103546.
4. Fu Shaw L, Chang P-C, Lee J-F, Kung H-Y, Tung T-H. Incidence and predicted risk factors of pressure ulcers in surgical patients: experience at a medical center in Taipei, Taiwan. BioMed research international. 2014;2014.
5. Jiang L, Li L, Lommel L. Nurses’ knowledge, attitudes, and behaviours related to pressure injury prevention: A large‐scale cross‐sectional survey in mainland China. Journal of clinical nursing. 2020;29(17-18):3311-24.
6. Karimian M, Sarokhani D, Sarokhani M, Sayehmiri K, Mortazavi Tabatabai SA. Prevalence of Bedsore in Iran: A Systematic Review and Meta-analysis. Journal of Mazandaran University of Medical Sciences. 2016;26(136):202-10.
7. Okhovati S, Esmaeili M, Shariat E. Effect of intensive care unit nurses' empowerment program on ability in visual differential diagnosis of pressure ulcer classification. Critical care nursing quarterly. 2019;42(1):89-95.
8. Zarei E, Madarshahian E, Nikkhah A, Khodakarim S. Incidence of pressure ulcers in intensive care units and direct costs of treatment: Evidence from Iran. Journal of tissue viability. 2019;28(2):70-4.
9. Llaurado-Serra M, Afonso E. Pressure injuries in intensive care: what is new? Intensive & critical care nursing. 2018;45:3-5.
10. Tayyib N, Coyer F. Effectiveness of pressure ulcer prevention strategies for adult patients in intensive care units: a systematic review. Worldviews on Evidence‐Based Nursing. 2016;13(6):432-44.
11. Tayyib N, Coyer F, Lewis P. Saudi Arabian adult intensive care unit pressure ulcer incidence and risk factors: a prospective cohort study. International wound journal. 2016;13(5):912-9.
12. Galvمo NS, Serique MAB, Santos VLCdG, Nogueira PC. Knowledge of the nursing team on pressure ulcer prevention. Revista Brasileira de enfermagem. 2017;70:294-300.
13. Alderden, J, Cummins M, Zaratkiewicz, S, 'Lucy' Zhao Y, Drake K, Yap TL. Hospital-Acquired Pressure Injury Development Among Surgical Critical Care Patients Admitted With Community-Acquired Pressure Injury: A Retrospective Cohort Study. Journal of wound, ostomy, and continence nursing. 2020;47(5): 470–476.
14. De Meyer D, Verhaeghe S, Van Hecke A, Beeckman D. Knowledge of nurses and nursing assistants about pressure ulcer prevention: A survey in 16 Belgian hospitals using the PUKAT 2.0 tool. Journal of tissue viability. 2019;28(2):59-69.
15. Demarré L, Van Lancker A, Van Hecke A, Verhaeghe S, Grypdonck M, Lemey J, et al. The cost of prevention and treatment of pressure ulcers: a systematic review. International journal of nursing studies. 2015;52(11):1754-74.
16. Nuru N, Zewdu F, Amsalu S, Mehretie Y. Knowledge and practice of nurses towards prevention of pressure ulcer and associated factors in Gondar University Hospital, Northwest Ethiopia. BMC nursing. 2015;14(1):1-8.
17. Lovegrove J, Miles S, Fulbrook P. The relationship between pressure ulcer risk assessment and preventative interventions: a systematic review. Journal of wound care. 2018;27(12):862-75.
18. Kottner J, Cuddigan J, Carville K, Balzer K, Berlowitz D, Law S, Litchford M, Mitchell P, Moore Z, Pittman J, Sigaudo-Roussel D. Prevention and treatment of pressure ulcers/injuries: The protocol for the second update of the international Clinical Practice Guideline 2019. Journal of tissue viability. 2019 May 1;28(2):51-8.
19. Baernholdt M, Yan G, Hinton ID, Cramer E, Dunton N. Effect of preventive care interventions on pressure ulcer rates in a national sample of rural and urban nursing units: Longitudinal associations over 4 years. International journal of nursing studies. 2020;105:103455.
20. Grešš Halász B, Bérešová A, Tkáčová Ľ, Magurová D, Lizáková Ľ. Nurses’ knowledge and attitudes towards prevention of pressure ulcers. International Journal of Environmental Research and Public Health. 2021;18(4):1705.
21. Hekmatpou D, Mehrabi F, Rahzani K, Aminiyan A. The effect of Aloe Vera gel on prevention of pressure ulcers in patients hospitalized in the orthopedic wards: a randomized triple-blind clinical trial. BMC complementary and alternative medicine. 2018;18(1):1-11.
22. Garrigues LJ, Cartwright JC, Bliss DZ. Attitudes of nursing students about pressure injury prevention. Journal of Wound, Ostomy and Continence Nursing. 2017;44(2):123-8.
23. Avsar P, Patton D, O'Connor T, Moore Z. Do we still need to assess nurses' attitudes towards pressure ulcer prevention? A systematic review. Journal of Wound Care. 2019;28(12):795-806.
24. Khojastehfar S, Najafi Ghezeljeh T, Haghani S. Knowledge and attitude of intensive care nurses regarding the prevention of pressure ulcer. Iran Journal of Nursing. 2019;31(116):5-17.
25. Pancorbo‐Hidalgo PL, García‐Fernández FP, López‐Medina IM, López‐Ortega J. Pressure ulcer care in Spain: nurses’ knowledge and clinical practice. Journal of Advanced Nursing. 2007;58(4):327-38.
26. Iranmanesh S, Rafiei H, Foroogh Ameri G. Critical care nurses' knowledge about pressure ulcer in southeast of Iran. International wound journal. 2011;8(5):459-64.
27. Yan B, Dandan H, Xiangli M. Effect of training programmes on nurses' ability to care for subjects with pressure injuries: A meta‐analysis. International Wound Journal. 2022 Feb;19(2):262-71.
28. Dalvand S, Ebadi A, Gheshlagh RG. Nurses’ knowledge on pressure injury prevention: a systematic review and meta-analysis based on the Pressure Ulcer Knowledge Assessment Tool. Clinical, cosmetic and investigational dermatology. 2018;11:613.
29. Kielo E, Suhonen R, Ylِnen M, Viljamaa J, Wahlroos N, Stolt M. A systematic and psychometric review of tests measuring nurses' wound care knowledge. International Wound Journal. 2020;17(5):1209-24.
30. Lumbers M. Wound debridement: Choices and practice. British Journal of Nursing. 2018 Aug 9;27(15):S16-20.
31. Saleh MY, Papanikolaou P, Nassar OS, Shahin A, Anthony D. Nurses' knowledge and practice of pressure ulcer prevention and treatment: an observational study. Journal of tissue viability. 2019;28(4):210-7.
32. Farzi S, Farzi S, Yousefii H, Moladoost A, Moieni M. Knowledge, attitue and practice of nurses concerning pressure ulcer prevention and its relationship with some demographic characteristics. Iranian Journal of Nursing Research. 2016 Oct 10;11(4):66-71.
33. Ghazanfari MJ, Karkhah S, Maroufizadeh S, Fast O, Jafaraghaee F, Gholampour MH, Zeydi AE. Knowledge, attitude, and practice of Iranian critical care nurses related to prevention of pressure ulcers: A multicenter cross-sectional study. Journal of tissue viability. 2022 May 1;31(2):326-31.
34. Zeydi AE, Ghazanfari MJ, Esmaeili S, Mobayen M, Soltani Y, Sigaroudi AE, Fast O, Karkhah S. Knowledge, attitude, and practice of Iranian nurses towards pressure ulcer prevention: a systematic review. Journal of Tissue Viability. 2022 Aug 1;31(3):444-52.