Training needs and self-rated competence in pressure injury prevention among clinical nurses: a multicenter...

Pressure injury prevention relies heavily on nurses' ability to recognize risk, implement preventive measures and respond promptly to early skin changes. Before developing large-scale training programs, it is important to understand nurses' current self-rated competence and their learning needs. This study assessed clinical nurses' self-rated knowledge, attitudes, self-reported practices and training needs related to pressure injury prevention in a multicenter sample.

A multicenter cross-sectional survey was conducted among 997 clinical nurses from 34 hospitals. Data were collected using an online questionnaire covering demographic characteristics, self-rated pressure injury-related knowledge, attitudes, self-reported preventive practices and training needs. Domain scores were standardized to a 0-100 scale. Descriptive analyses were used to summarize item-level findings and training needs. Subgroup comparisons were performed to examine differences in knowledge, attitude and practice (KAP) domain scores across professional and institutional groups. Exploratory multivariable linear regression was used to examine factors associated with self-reported practice scores.

The mean standardized scores for self-rated knowledge, attitude and self-reported practice were 91.24 ± 10.87, 95.05 ± 9.38 and 77.44 ± 20.23, respectively. Attitude scores were high, while self-reported practice scores were lower and more widely distributed. Areas requiring further attention included dressing use, stage-specific management, pressure-relief strategies, consultation with wound, ostomy and continence specialist teams, and wound photo documentation. Nurses working in hospitals with pressure injury specialist teams reported higher KAP domain scores. In exploratory multivariable analysis, hospital specialist team status was associated with higher self-reported practice scores after adjustment. Training needs were high, with hands-on bedside instruction, online video learning and continuing education lectures being the most preferred approaches.

This multicenter survey showed that nurses generally held positive attitudes toward pressure injury prevention, but gaps remained in self-rated knowledge and self-reported practice, especially in areas requiring clinical judgment, documentation and hands-on skills. These findings may inform the development of needs-based, blended education that combines online learning with bedside guidance, case-based discussion and specialist team input.