Cross-Sectional Mediation Analysis: How Registered Nurses' Knowledge, Attitude, and Practice Influence Adherence to...

Area of Science:

• Healthcare Quality and Safety
• Nursing Research
• Patient Care Management

Background:

• Pressure injuries (PIs) are a significant global patient safety issue with high prevalence and mortality.
• The economic impact of PIs is substantial, necessitating improved prevention strategies.
• Inconsistent adherence to pressure injury prevention (PIP) guidelines among registered nurses (RNs) is a critical concern.

Purpose of the Study:

• To investigate the mediating roles of attitude and practice in the relationship between knowledge and adherence to PIP guidelines among RNs.
• To assess RNs' knowledge, attitude, and practice (KAP) concerning PIP guidelines.
• To evaluate the direct relationship between knowledge and adherence, and quantify the mediated pathways.

Main Methods:

• A cross-sectional mediation study involving 166 RNs from Prince Sultan Military Medical City, KSA.
• Data collected using validated instruments for KAP and PIP guideline adherence.
• Statistical analyses included Pearson correlations, multiple linear regression, and parallel mediation analysis with covariates.

Main Results:

• RNs demonstrated low knowledge (29.2%), negative attitude (54.2%), poor practice (32.8%), and low adherence (31.6%) to PIP guidelines.
• Knowledge, attitude, practice, and years of experience were significant predictors of adherence.
• Attitude and practice significantly mediated the relationship between knowledge and adherence, indicating partial mediation.

Conclusions:

• This study highlights that adherence to PIP guidelines is influenced by interconnected cognitive and behavioral factors (KAP).
• The findings underscore the need for integrated interventions to enhance KAP and improve adherence to PIP guidelines.
• Addressing low KAP levels and improving adherence are crucial for effective pressure injury prevention in healthcare settings.