Nurses' Knowledge, Attitudes, and Practices in Pressure Injury Prevention: A Systematic Review and Meta-Analysis

Background: Various methods for preventing pressure injury have been developed across the globe, particularly in Saudi Arabia. Current available research has investigated the knowledge, attitudes, and practices regarding pressure injury prevention. However, no systematic review and meta-analysis have yet examined the associations among knowledge, attitudes, and practices regarding pressure injury prevention based on the perspectives of registered nurses. Objective: This study examines and summarizes the reported relationships among knowledge, attitudes, and practices regarding pressure injury prevention on the basis of the perceptions of registered nurses. Methods: The CINAHL, ProQuest, PubMed, ScienceDirect, and Web of Science databases were searched for quantitative evidence published in English between 2019 and 2025. The systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (2021) guidelines. Results: Out of the 1986 records that were initially examined, a total of 10 quantitative, cross-sectional, and correlational studies were included in the final systematic review and meta-analysis. In the context of the meta-analysis, 10 studies were included for the association between knowledge and attitudes, whereas only 3 studies were available for the association between knowledge and practice, and similarly, only 3 studies addressed the association between attitudes and practice of pressure injury prevention. Collectively, 2457 registered nurses were involved in these studies, mostly working in intensive care units. The studies were conducted in various countries across Asia and the Middle East, mostly in Turkiye, within the last five years. The registered nurses in the 10 studies reported associations among knowledge, attitudes, and practices toward pressure injury prevention that ranged from insignificant to weak, indirect, and strong direct. Conclusions: Relationships among knowledge, attitudes, and practices toward pressure injury prevention are both positive and negative from the global perspective and are shaped by various confounding and mediating factors, including socio-demographic, nursing-related, and hospital-related factors. Improving the knowledge base of registered nurses and promoting a favorable attitude toward pressure ulcer prevention would provide healthcare organizations with the potential to enhance the already commendable levels of practice and prevention noted in this review.