Nurse knowledge, attitudes, and barriers to pressure injuries: A cross-sectional study in an Australian metropolitan teaching hospital

Background: Pressure injuries are associated with significant clinical complications with negative effects on the patient's emotional, psychological, social and physical wellbeing. However, in Australia little is known about the knowledge and attitudes of nurses towards hospital-acquired pressure injuries. Objective: To determine nurse knowledge and attitudes towards hospital-acquired pressure injuries and to identify barriers towards prevention. Methods: A cross-sectional study following the STROBE statement was conducted between May to July in 2017. All nurses at a major metropolitan teaching hospital in Western Australia were invited to participate. Nurse knowledge and attitude to pressure injury were assessed using validated Pressure Ulcer Knowledge Assessment tool, and Attitude towards Pressure Ulcer Prevention tool. An open-ended question asked about the barriers to pressure injury prevention. Quantitative data were analysed using descriptive and inferential statistics and answers for the open-ended question were analysed using thematic analysis. Results: Data from 224 nurses (response rate 19.0 %) were analysed. While nurses displayed a satisfactory attitude towards hospital-acquired pressure injury prevention, most nurses lacked adequate knowledge of the stages, causes and prevention of pressure injuries. Thematic analysis of responses to the open-ended question yielded two main themes: modifiable barriers to pressure injury prevention were lack of knowledge, attitude of pressure injury prevention and the scarcity of resources. Non-modifiable barriers to pressure injury prevention were the nursing environment and patient characteristics. Conclusion: Most nurses have satisfactory attitude towards pressure injury prevention, but inadequate knowledge about pressure injuries. Barriers to pressure injury prevention are attributed to nurse working environments, particularly impeded by staffing, time constraints and resources.