The Practice Experience of ICU Nurses in Preventing Pressure Injuries: A Qualitative Meta-Synthesis

This study sought to synthesize qualitative evidence pertaining to intensive care unit (ICU) nurses' experiences in pressure injury prevention and thereby to systematically delineate the facilitators and barriers shaping these behaviors so as to support the formulation of targeted intervention strategies.

A qualitative meta-synthesis was conducted following the Joanna Briggs Institute methodology and was underpinned by the Theoretical Domains Framework alongside the Capability-Opportunity-Motivation-Behaviour (COM-B) model.

A systematic search was performed across nine databases-namely PubMed, Web of Science, Cochrane Library, Embase, CINAHL, China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Database and China Biomedical Literature Database-covering the period from database inception to 21 January 2026. Two researchers independently undertook study screening and data extraction. Study quality was evaluated using the 2016 iteration of the Qualitative Research Quality Assessment Tool developed by the Joanna Briggs Institute. Extracted findings were subsequently mapped and synthesized according to the Theoretical Domains Framework and the COM-B model.

PubMed, Web of Science, Cochrane Library, Embase, CINAHL, CNKI, Wanfang Database, VIP Database and China Biomedical Literature Database.

Twelve studies were included from which 52 discrete findings were derived. Following a process of mapping and synthesis guided by the Theoretical Domains Framework and the COM-B model, the various facilitators and barriers associated with ICU nurses' pressure injury prevention practices were consolidated into 13 distinct categories and two overarching synthesized findings.

Pressure injury prevention practices among ICU nurses constitute a complex behavioral process whose formation involves multiple interacting elements. Future intervention efforts should therefore adopt coordinated strategies that simultaneously address the enhancement of knowledge and skill development alongside the optimization of resource and environmental conditions while also reinforcing individual beliefs and motivation so as to elevate the overall quality of preventive care.

Healthcare providers are encouraged to implement multi-component approaches that concurrently support the development of nurses' clinical competencies and the improvement of organizational resources and that further cultivate sustained motivation, thereby ensuring the delivery of high-quality pressure injury prevention within intensive care environments.

By systematically identifying the principal facilitators and barriers that influence ICU nurses' pressure injury prevention practices, this study offers an evidence-informed basis for designing comprehensive interventions aimed at improving prevention quality and patient outcomes in critical care settings.

This study adheres to the Joanna Briggs Institute methodology for meta-aggregation and its reporting conforms to the ENTREQ guideline.

No patient or public contribution was made.

PROSPERO database: CRD420261286790.