Critical Care Nurses’ Knowledge, Attitudes, and Perceived Barriers towards Pressure Injuries Prevention

  • Abstract
  • Keywords
  • References
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  • Abstract

    Background: Pressure injuries are a considerable problem for hospitalized critically ill and elderly patients, as such injuries produce pain, and reduce total wellbeing, resulting in increased morbidity and mortality, as well as often extending those patients’ hospital stays

    Purpose: The purpose of this study was to determine critical care nurses knowledge, attitudes, and perceived barriers toward pressure injuries prevention.

    Design: A descriptive cross-sectional survey was performed, using a questionnaire method to critical care nurses’. The study took place between August and October 2017 and involved ten hospitals: two university hospital, six public hospitals, and two private hospitals.  

    Methods: Data were collected by means of a questionnaire using two valid and reliable instruments: i) the Pressure Ulcer Knowledge Assessment Tool 2⋅0, and ii) Attitude Toward Pressure Ulcer Prevention and two newly developed instruments sociodemographic and perceived barriers toward pressure injury prevention.

    Results: The entire mean knowledge score for the participants was 54.9%, and overall high attitude scores were 76.7%. Level of education, years employed in a critical care unit, training received on pressure injury prevention, and the number of papers read on pressure injury prevention was all identified as having a significant and independent effect on participants’ knowledge concerning prevention of pressure injuries. To evaluate the effect of demographic characteristics on nurses’ attitudes, the only significant variable was "years of employment in critical care units". Shortage of staff was the most commonly cited barrier faced by critical care nurses’ during practice.

  • Keywords

    Attitudes, Barriers, Critical care nurses’, Jordan, Knowledge, Pressure injuries

  • References

      [1] Ajzen I, Gilbert Cote N. Attitudes and the prediction of behavior. (2008). In: Crano WD, Prislin R, editors. Attitudes and attitude change. New York: Psychology Press; p. 289—311.

      [2] Ajzen, I. (2011). The theory of planned behaviour: reactions and reflections.‏Psychology & Health, 26(9), 1113–1127.DOI:

      [3] Bashayreh, I., Saifan, A., Batiha, A. M., & Abu Ruz, M. (2013). Family Presence during CPR in Adult Critical Care Settings: Hearing the Voice of Jordanian Health Professionals. Life Science Journal, 10(4), 1738-1748.‏

      [4] Bashayreh, I., Saifan, A., Batiha, A. M., Timmons, S., & Nairn, S. (2015). Health professionals’ perceptions regarding family witnessed resuscitation in adult critical care settings. Journal of clinical nursing, 24(17-18), 2611-2619.

      [5] Batiha, A. M. (2014). Pain management barriers in critical care units: A qualitative study. International Journal of Advanced Nursing Studies, 3(1), 1.‏

      [6] Beeckman, D., Defloor, T., Demarré, L., Van Hecke, A., & Vanderwee, K. (2010). Pressure ulcers: Development and psychometric evaluation of the Attitude towards Pressure ulcer Prevention instrument (APuP). International Journal Of Nursing Studies, 47(11), 1432-1441. doi:10.1016/j.ijnurstu.2010.04.004

      [7] Beeckman, D., Defloor, T., Schoonhoven, L., & Vanderwee, K. (2011). Knowledge and attitudes of nurses on pressure ulcer prevention: a cross-sectional multicenter study in Belgian hospitals. Worldviews On Evidence-Based Nursing, 8(3), 166-176. doi:10.1111/j.1741-6787.2011.00217.x

      [8] Beeckman, D., Vanderwee, K., Demarré, L., Paquay, L., Van Hecke, A., & Defloor, T. (2010). Pressure ulcer prevention: development and psychometric validation of a knowledge assessment instrument. International Journal Of Nursing Studies, 47(4), 399-410. doi:10.1016/j.ijnurstu.2009.08.010

      [9] Cox, J. , Schallorm, M., 2017. Pressure Injuries in Critical Care: A Survey of Critical Care Nurses. Critical Care Nurse, 37(5), 46-56. doi:10.4037/ccn2017928

      [10] Dilie, A., & Mengistu, D. (2015). Assessment of Nurses’ Knowledge, Attitude, and Perceived Barriers to Expressed Pressure Ulcer Prevention Practice in Addis Ababa Government Hospitals, Addis Ababa, Ethiopia, 2015. Advances In Nursing, 2015(1), doi:10.1111/j.1471-6712.2008.00627.x

      [11] El Enein, N. A., & Zaghloul, A. A. (2011). Nurses' knowledge of prevention and management of pressure ulcer at a health insurance hospital in Alexandria. International Journal Of Nursing Practice, 17(3), 262-268. doi:10.1111/j.1440-172X.2011.01933.x

      [12] Galvão, N. S., Serique, M. A. B., Santos, V. L. C. D. G., &Nogueira, P. C.(2017). Knowledge of the nursing team on pressure ulcer prevention. RevistaBrasileira De Enfermagem, 70(2), 294-300. doi:10.1590/0034-7167-2016-0063

      [13] Ilesanmi, R. E., Ofi, B. A., & Adejumo, P. O. (2012). Nurses' knowledge of pressure ulcer prevention in ogun state, Nigeria: results of a pilot survey . Ostomy/Wound Management, 58(2), 24-32.

      [14] Källman, U., & Suserud, B. (2009). Knowledge, attitudes and practice among nursing staff concerning pressure ulcer prevention and treatment--a survey in a Swedish healthcare setting. Scandinavian Journal Of Caring Sciences, 23(2), 334-341.

      [15] Manderlier, B., Van Damme, N., Vanderwee, K., Verhaeghe, S., Van Hecke, A., & Beeckman, D. (2017). Development and psychometric validation of PUKAT2•0, a knowledge assessment tool for pressure ulcer prevention. International Wound Journal, 14(6), 1041-1051.doi:10.1111/iwj.12758

      [16] Nuru, N., Zewdu, F., Amsalu, S., & Mehretie, Y. ,2015. Knowledge and practice of nurses towards prevention of pressure ulcer and associated factors in Gondar University Hospital, Northwest Ethiopia. BMC Nursing, 14(1), 1-8. doi:10.1186/s12912-015-0076-8

      [17] Obead, K. A., Batiha, A. M., Al-Jauissy, M. S., Alhalaiqa, F., & AlBashtawy, M. (2014). Impact of radiotherapy treatment on Jordanian cancer patients' quality of life and fatigue. International Journal of Advanced Nursing Studies, 3(1), 6-12.‏

      [18] Ozyurek, P., & Yavuz, M. (2015). Prevention of pressure ulcers in the intensive care unit: a randomized trial of 2 viscoelastic foam support surfaces. Clinical Nurse Specialist, 29(4), 210-217. doi:10.1097/NUR.0000000000000136

      [19] Qaddumi, J., & Khawaldeh, A. (2014). Pressure ulcer prevention knowledge among Jordanian nurses: a cross- sectional study. BMC Nursing, 13(1), 6. doi:10.1186/1472-6955-13-6

      [20] Qaseem, A., Humphrey, L. L., Forciea, M. A., Starkey, M., &Denberg, T. D. (2015). Treatment of Pressure Ulcers: A Clinical Practice Guideline From the American College of Physicians. Annals Of Internal Medicine, 162(5), 370-379. doi:10.7326/M14-1568

      [21] Sardo, P., Simões, C., Alvarelhão, J., Costa, C., Simões, C. J., Figueira, J., & ... Melo, E. (2015). Pressure ulcer risk assessment: retrospective analysis of Braden Scale scores in Portuguese hospitalised adult patients. Journal Of Clinical Nursing, 24(21/22), 3165-3176. doi:10.1111/jocn.12927

      [22] Schlüer, A. (2017). Pressure ulcers in maturing skin – A clinical perspective. Journal Of Tissue Viability, 26(1), 2-5.doi:10.1016/j.jtv.2016.10.001

      [23] Serpa, L. F., Santos, V. G., Oliveira, A. S., Caetano, V. C., &Donadon, S. R. (2011). Incidence of pressure ulcers in critical care patients. RevistaEstima, 9(3), 21-26.

      [24] Simonetti, V., Comparcini, D., Flacco, M. E., Di Giovanni, P., &Cicolini, G. , 2015. Nursing students' knowledge and attitude on pressure ulcer prevention evidence-based guidelines: A multicenter cross-sectional study. Nurse Education Today, 35(4), 573-579.doi:10.1016/j.nedt.2014.12.020

      [25] Strand, T., & Lindgren, M. (2010). Knowledge, attitudes and barriers towards prevention of pressure ulcers in intensive care units: A descriptive cross-sectional study. Intensive And Critical Care Nursing, 26(6), 335-342. doi:10.1016/j.iccn.2010.08.006

      [26] Tawalbeh, L. I., Tubaishat, A., Batiha, A.M., Al-Azzam, M., & AlBashtawy, M. (2015). The relationship between social support and adherence to healthy lifestyle among patients with coronary artery disease in the north of Jordan. Clinical Nursing Research, 24(2), 121-138.

      [27] Tubaishat, A., Aljezawi, M., & Al Qadire, M. ,2013. Nurses' attitudes and perceived barriers to pressure ulcer prevention in Jordan. Journal Of Wound Care, 22(9), 490-497.doi:10.12968/jowc.2013.22.9.490

      [28] Tubaishat, A., Anthony, D., & Saleh, M. (2011). Pressure ulcers in Jordan: a point prevalence study. Journal Of Tissue Viability, 20(1), 14-19. doi:10.1016/j.jtv.2010.08.001

      [29] Ünver, S., Fındık, Ü. Y., Özkan, Z. K., &Sürücü, Ç. (2017). Attitudes of surgical nurses towards pressure ulcer prevention. Journal Of Tissue Viability, 26(4), 277-281. doi:10.1016/j.jtv.2017.09.001

      [30] Usher, K., Woods, C., Brown, J., Power, T., Lea, J., Hutchinson, M., & ... Jackson, D. (2018). Australian nursing students' knowledge and attitudes towards pressure injury prevention: A cross-sectional study. International Journal Of Nursing Studies, 8114-20. doi:10.1016/j.ijnurstu.2018.01.015

      [31] Yamada, H., Inoue, Y., Shimokawa, Y., & Sakata, K. (2017). Skin stiffness determined from occlusion of a horizontally running microvessel in response to skin surface pressure: a finite element study of sacral pressure ulcers. Medical & Biological Engineering & Computing, 55(1), 79-88. doi:10.1007/s11517-016-1500-2




Article ID: 22716
DOI: 10.14419/ijans.v7i2.22716

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