Australian Nurses' Knowledge of Pressure Injury Prevention and Management: A Cross-sectional Survey

Abstract

PURPOSE: The aim of this study was to assess nurses' knowledge of pressure injuries in order to gather benchmark data, identify knowledge gaps, and based on results, implement educational strategies to improve practice. DESIGN: Cross-sectional survey. SUBJECTS AND SETTING: The study setting was a large Australian tertiary general hospital employing approximately 2500 nurses in both full-Time and part-Time roles. A proportional sample (25%) stratified by experience, preparation, and facility-generated categories (nursing grade) was generated. The sample included nursing students and nursing assistants. Three hundred six participants completing the survey. INSTRUMENT: The Pieper-Zulkowski Pressure Ulcer Knowledge Test (PZPUKT) version 2, comprising 72 statements, with 3 subscales (prevention/risk, staging, and wound description) was used to measure pressure injury knowledge. Item responses are "True," "False," and "Don't know." For the purpose of analyses, correct responses were scored 1, and incorrect or "don't know" responses were scored 0. Generally accepted ranges of scoring for the original PZPUKT specify less than 70% as unsatisfactory, 70% to 79.9% as satisfactory, 80% to 89.9% as good, and 90% and greater as very good knowledge of pressure injury prevention. METHODS: The survey was advertised throughout the hospital by strategically placed posters, computer screen savers within the hospital, and e-mails. Respondents completed paper-based questionnaires and data were manually entered online. Data were collected between September 2015 and October 2016. Descriptive and nonparametric inferential statistical tests (Mann-Whitney U, Kruskal-Wallis H) were used to analyze within sample differences in scores. RESULTS: The overall mean knowledge score was 65%; approximately two-Thirds of the sample (68%) scored 60% and greater, reflecting an unsatisfactory knowledge level of pressure injury prevention according to the original PZPUKT scores. The lowest mean scores were found in the "wound description" subscale. Participants who sought pressure injury information via the Internet or had read pressure injury guidelines scored significantly higher than those who did not (P =.001 and P