Nurses' and nursing students' knowledge and attitudes to pressure injury prevention: A meta-analysis based on APUP and PUKAT

Background: Morbidity and mortality among patients due to pressure injuries continue to rise. Nurses play a critical role in preventing pressure injuries. However, published results on nurses' knowledge and attitudes for pressure injury prevention are often contradictory.Objectives: To conduct a meta-analysis of nurses' and nursing students' knowledge and attitudes toward pressure injury prevention.Design: A meta-analysis of cross-sectional studies.Data sources: Ten databases were queried for the meta-analysis. The search period was from the time of the databases' establishment to February 2023.Review methods: This review followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The Agency for Healthcare Research and Quality (AHRQ) was used to assess the methodological quality of the included studies. Statistical analysis was conducted with the Stata 15.0 software, and the quantitative data of knowledge and attitude toward preventing PI in all studies were summarized.Results: Thirteen studies from 9 countries were included. The meta-analysis showed that nurses and nursing students had low knowledge but positive attitudes toward pressure injury prevention. Subgroup analysis showed that the pooled proportion of both knowledge and attitudes was higher in Asia than in Europe. Nurses had higher knowledge than nursing students, however, the former had a more negative attitude than the latter. Sensitivity analyses were robust. Egger's test showed no significant publication bias.Conclusion: The knowledge of nurses and nursing students about pressure injury prevention is not promising and there is an urgent need for continuous learning. Attitudes are more positive but there is room for improvement. The relevant departments should strengthen nurses' and nursing students' knowledge of pressure injury prevention and further improve their attitudes toward pressure injury prevention.