Nurses’ knowledge on pressure injury prevention in an acute hospital in Malta: a comparative cross-sectional study

Background: Pressure injury (PI) prevention is an increasing concern for hospitals worldwide. Inadequate knowledge among nurses can contribute to improper PI prevention and management, potentially leading to complications, such as infections, delayed healing and increased patient discomfort. These complications may result in longer hospital stays and higher readmission rates, ultimately escalating healthcare costs. However, published local research on PI prevention in acute care settings remains limited, highlighting the need for further studies. Objectives: To investigate whether nurses working in an acute hospital in Malta are knowledgeable enough on PI prevention. To assess the barriers perceived by nurses that hinder them from applying the evidence-based PI prevention methods. To ascertain whether sociodemographic characteristics influence the nurses’ knowledge. Designs and Methods: A comparative, cross-sectional study was completed using a paper-based questionnaire to collect data. Copies were distributed among 626 nurses and obtained a response rate of 38.7% (n=242). Data collection tools included a Pressure Ulcer Knowledge Test and a survey assessing perceived barriers to the application of pressure injury prevention. Population: All nurses working in an acute hospital in Malta excluding nurses working in paediatrics, outpatients and emergency departments were invited to participate in the study. Results: A low level of knowledge (44.6%) regarding PI prevention was found. The number of perceived barriers hindering nurses from implementing PI prevention methods was also high (56.6%). Nurses with more clinical experience and who read relevant literature had a higher level of knowledge than other participants. Nurses with a degree perceived a larger number of barriers than nurses with a diploma, and statistical differences were found between the number of perceived barriers and clinical experience. Participants who read the literature or attended training perceived fewer barriers hindering them from applying appropriate PI prevention methods. A weak negative correlation was identified between nurses’ level of knowledge and the number of perceived barriers encountered by participants. Conclusion: Nurses in an acute Maltese hospital showed low knowledge and high perceived barriers to PI prevention. Experience, education and reading relevant literature improved outcomes. Targeted training and better access to resources are needed to enhance evidence-based practice and improve patient care.