Knowledge Gaps and Pressure-Injury Prevention Practices Among Nurses in Tertiary-Care Hospitals: A Multicenter Cross-Sectional Study.

Abstract

Background: Pressure injuries (PIs) remain an important patient-safety concern, and nurses play a central role in their prevention. However, limitations in PI prevention knowledge and inconsistencies in preventive practices continue to be reported, particularly in resource-variable healthcare settings.

Objective: To assess nurses’ knowledge and self-reported practices regarding PI prevention and examine the relationship between knowledge, preventive practices, and selected professional characteristics.

Methods: A multicenter cross-sectional study was conducted among 138 registered nurses from selected public and private healthcare facilities in Kasur and Lahore, Punjab, Pakistan. Data were collected using a structured self-administered questionnaire assessing demographic and professional characteristics, PI prevention knowledge, and self-reported preventive practices. Descriptive statistics, Spearman’s correlation, one-way analysis of variance, and simple linear regression were used for analysis.

Results: Participants answered approximately 46% of the PI prevention knowledge items correctly, while the mean prevention-practice score was 3.49 ± 0.25 on a five-point scale. Knowledge showed a very weak, non-significant correlation with preventive practice (ρ = 0.051, p = 0.551). Knowledge and practice did not differ significantly according to nursing experience, previous PI prevention training, training recency, frequency of caring for at-risk patients, or guideline availability. Knowledge, age, previous training, and guideline availability were also not significant individual predictors of preventive practice.

Conclusion: Nurses demonstrated limitations in overall PI prevention knowledge despite reporting moderate-to-frequent preventive practices. Knowledge alone was not associated with self-reported practice, suggesting that PI prevention may also depend on educational, clinical, and organizational factors. Strengthening competency-based education alongside effective implementation of evidence-based protocols and supportive clinical systems may improve PI prevention.