Operating room nurses’ knowledge of and attitudes about pressure injury prevention: a descriptive cross-sectional study
Künye
Kandemir, D., Ozhanli, Y., Erdogan, H., Temiz, Z. (2022). Operating Room Nurses’ Knowledge of and Attitudes About Pressure Injury Prevention: A Descriptive Cross-Sectional Study. Wound Management & Prevention, 68(12).Özet
BACKGROUND: Understanding nurses’ knowledge and attitudes might be important in influencing their behaviors of complying with pressure injury prevention measures in the operating room. PURPOSE: The aim of this descriptive and cross-sectional study was to determine operating room nurses’ knowledge and attitudes about pressure injury prevention. METHODS: This study was performed with 174 nurses working in the operating rooms of 5 hospitals in Istanbul between July and October 2020. The data were collected with the Modified Pieper Pressure Ulcer Knowledge Test-MPPUKT and Attitude Towards Pressure Ulcer Prevention Instrument-APuP and analyzed with parametric and nonparametric tests using the SPSS 20.0 package program. The statistical significance level was accepted as P < .05. RESULTS: The total mean score of the MPPUKT of the operating room nurses was 32.72 ± 6.65, and the knowledge level of only 57.5% of the nurses was considered sufficient (MPPUKT score ≥ 70%); the total mean score of the APuP was 44.67 ± 3.10, and almost all (94.8%) had a satisfactory attitude (≥75%). In addition, there was a significant positive correlation between the knowledge and attitudes of the operating room nurses about pressure injury prevention (P = .000). CONCLUSION: This study has shown that the knowledge level of the operating room nurses was weak and their attitudes were satisfactory. It is recommended to improve the knowledge and attitudes of operating room nurses to prevent pressure injuries through effective in-service training programs.
Pressure injury is defined as localized damage to the skin or deep tissues, usually on a bony prominence or in association with a medical or other devices.1 Any pressure injury that develops within 48 to 72 hours intra-, inter-, or postoperatively in a patient undergoing surgical intervention is described as a perioperative pressure injury, and the anatomical position is associated with the operating position.2-4 The incidence of perioperative pressure injuries ranges from 1.3% to 51%, and this rate constitutes 45% of all hospital-acquired pressure injuries.3,5,6
Pressure injury is an important indicator of international health care quality.1,3,7 These injuries are usually difficult to heal, painful, negatively affect the health-related quality of life of the individual,7-9 and increase length of hospital stay and health care costs.7,10 Thus, the ideal is to prevent the development of pressure injury4; diagnosis at its earliest stage is essential to allow planning for cost-effective care.9
Although a multidisciplinary team approach plays a key role in preventing pressure injury, nurses are at the forefront of this effort in most healthcare settings.9,11 Monitoring and maintaining skin integrity and preventing skin damage is the primary responsibility of the nurse.7,8,10 In this context, to provide safe and quality nursing care, nurses should routinely evaluate the surgical patient’s skin for the presence of pressure injury during the perioperative period.4 However, pressure injury prevention requires risk assessment that involves a complex interaction of care planning, implementation, and evaluation. To be successful, nurses must be aware of the risk factors associated with the development of pressure injury. In addition, the relevant elements of pressure injury prevention guidelines should be followed after the individual has been evaluated.8,9,12
In the literature, it is recommended to regularly evaluate the knowledge and attitudes of healthcare professionals regarding pressure injury prevention and management to facilitate compliance with clinical guidelines and to identify potential barriers and facilitators when initiating quality improvement initiatives.13 Evaluation of nurses’ knowledge and attitudes about pressure injury prevention contributes to the identification of training needs, opportunities to improve practice and priorities, and helps develop organization-specific interventions.10,13
The relationship between knowledge, attitude, and practice is both complex and not fully understood. In addition, the literature states that there is a gap between nurses’ knowledge and evidence-based practices in pressure injury prevention.10 Understanding nurses’ knowledge and attitudes may be important in influencing the behavior of complying with pressure injury prevention measures that directly lead to pressure injury preventative practices in the operating room.4 However, although there are a few studies2,14,15 on surgical nurses in the literature, there is only one study4 examining the knowledge and attitudes of operating room nurses about pressure injury prevention. Thus, the aim of this study is to determine operating room nurses’ knowledge and attitudes about pressure injury prevention.
Research questions were as follows: 1) What is operating room nurses’ knowledge level about pressure injury prevention? 2) What are operating room nurses’ attitudes about pressure injury prevention? 3) Is there a relationship between knowledge and attitudes about pressure injury prevention?