Nurses' Knowledge and Attitudes Toward Pressure Injury Prevention: A Systematic Review

Area of Science:

• Nursing Science
• Patient Safety Research
• Healthcare Quality Improvement

Background:

• Pressure ulcers (PUs), or pressure injuries (PIs), are a significant patient safety concern, especially in critical care.
• Nursing staff play a pivotal role in PU/PI prevention, but knowledge gaps and suboptimal practices can impact patient outcomes.

Purpose of the Study:

• To systematically review global evidence on nurses' knowledge, attitudes, and practices regarding PU/PI prevention.
• To identify factors influencing nurses' performance in preventing PUs/PIs.

Main Methods:

• A systematic review adhering to PRISMA guidelines was conducted.
• Searched multiple electronic databases for primary research articles published between 2011 and 2025.
• Included 29 studies with diverse geographical representation, using narrative synthesis due to heterogeneity.

Main Results:

• Nurses' knowledge regarding PU/PI prevention was frequently inadequate, particularly in specific prevention areas.
• Attitudes towards PU/PI prevention were generally positive, but preventive practices were often suboptimal.
• Barriers included staff shortages, high workload, limited resources, and insufficient institutional support.

Conclusions:

• Despite positive attitudes, significant gaps in nurses' knowledge and practices for PU/PI prevention persist globally.
• Structured education, simulation training, and enhanced organizational support are recommended to improve evidence-based prevention adherence.
• Future research should utilize experimental designs and standardized tools for robust evidence on PU/PI prevention.