Australian First-Year Nursing Student Knowledge and Attitudes on Pressure Injury Prevention: A Three-Year Educational Intervention Survey Study

Abstract

Pressure injury prevention is a significant issue as pressure injuries are difficult to heal, painful, and create clinical complications for patients. The aim of this study was to investigate knowledge and attitudes of first-year nursing students to pressure injury prevention, and to explore whether additional educational interventions augmented learning. A previously validated online survey was administered to three cohorts of first-year nursing students in 2016, 2017 (after additional online education), and 2018 (after further simulation education), and a subsequent comparative analysis was undertaken. Overall, the knowledge of students about pressure injury was low with measures to prevent pressure injury or shear achieving the lowest score (<50%). Students aged over 25 years (p < 0.001) and men (p = 0.14) gained higher attitude scores. There were significant differences for mean knowledge scores between the 2016 and 2018 cohorts (p = 0.04), including age group (p = 0.013) and number of clinical training units undertaken (p = 0.23). The 2016 cohort scored consistently lower in the attitude survey than both other cohorts (p < 0.001). Online resources and simulation experiences marginally improved knowledge and improved attitudes towards prevention of pressure injury. Nursing curricula should include targeted education to ensure student nurses are adequately prepared to prevent pressure injury through understanding of aetiology and risk assessment.

Student Nurse Knowledge of and Attitudes Toward Pressure Injury Prevention: How Sufficient Is Undergraduate Education?

“…The overall mean knowledge score in this study was 49.9% (11.7 ± 0.1). This is much lower than the scores reported by researchers using the same tool in Australia and other countries, such as Gunningberg et al 24 (58.9%), Simonetti et al 8 (51.1%), Mather et al 29 (55.4%), and Usher et al 15 (51.1%). It is higher than the mean knowledge score found by Kısacık and Sönmez 23 (38.2%) but lower than the 58% reported by Tülek et al 2 in Turkey.…”

“…In this study, the overall mean PUPKAI score was only 49.9% (11.7/26), and no student could answer all questions correctly; in addition, the overall mean ATPUPI score was 42.20 ± 2.40. A study conducted by Mather et al 29 with 472 student nurses showed that students lacked knowledge despite their positive attitudes toward PIs (mean score, 55.4%). Another study involving student nurses from seven universities in Australia reported a mean knowledge score of 51.1% and an attitude score of 40.8 ± 3.9 15 .…”

“…Treatment for PI costs 2.5 times more than prevention and negatively affects patient outcomes and cost 9 . The incidence of PIs is an accepted indicator that measures the standard of care 8,11,12 . Legal action against nurses as a result of neglect in preventing PIs has increased, and prevention of PIs is among the most important goals of healthcare services 10,13–15 …”

“…In addition to knowledge and clinical skills, a nurse’s attitude toward PIs is also important in the prevention and care of this condition 11 . Lack of knowledge about and a negative attitude toward PIs often affect the implementation of prevention strategies 12,15 . Although international guidelines have been developed to reinforce the importance and care of PIs, direct care nurses have a range of knowledge about PIs, and nursing students often do not have sufficient knowledge about current PI guidelines, preventing them from using them once they begin clinical work 15,17,18 .…”

A systematic review of nursing students' attitude and related factors towards pressure ulcer prevention

“…Such practice requires strong clinical judgement and appropriate visual assessment. 14 Despite the publication of clinical practice guidelines for the prevention of PUs two decades ago, 15 the incidence rate of these injuries is still high, with 2.5 million people suffering from them annually only in the United States. 16 The prevalence of PUs in various countries and medical settings has a wide range from 0% to 72.5%.…”