Assessment of knowledge and practice & identification of barriers towards pressure ulcer care and prevention among nursing professional

Abstract

Despite advances in health care, pressure ulcers (PrU) remain one of the most common and serious complications of spinal cord injury (SCI). Prevention of hospital-acquired PrU is an essential prerequisite for early reintegration of SCI patients into the society. Therein, lays the importance of awareness and knowledge about the prevention and management of PrU amongst nurses. The aim of this study was to assess nurses's knowledge of PU management to identify lacunas in implementation of PrU prevention strategies. It was a cross-sectional study. The participants completed a structured performa and Pressure Ulcer Knowledge Test (PUKT), which comprised of 47-items to examine the knowledge on PrU prevention, staging and wound description. A cutoff score of 90% of participants answering an item correctly was used to gauge “adequate” knowledge. Total 240 nurses participated in this study, out of which 87% were female, mean age 42.5 ± 10.49(yrs), more than 50% subjects had work experience of > 20 years. Mean total correct response was 59.01 ± 17.75 and to questions related to ulcer, wound and prevention was 56.19 ± 23.54, 52.98 ± 22.13, and 61.09 ± 18.09, respectively. A satisfactory percentage had adequate knowledge of prevention of PrU. However very poor response was observed to certain questions with only 7(2.92%) answering correctly about the use of Heel protectors and only 37(16.25%) aware about the role of eschar in ulcer healing. The mean PUKT score was < 60% for 41% of the participants. Nursing professionals involved in active care of patients performed significantly better in all the aspects of knowledge test. University training followed by In-service training was the source of education on PrU. Lack of resources and training (25%) & shortage of staff (23%) were the frequently cited barriers to carrying out PrU risk assessment, documentation and prevention. Our study identified deficits in PrU knowledge and areas where nurses would benefit from focused education strategies.