Knowledge, attitude, and practices of nurses toward the assessment and management of perioperative hidden blood loss among orthopedic patients: A cross-sectional multicenter study

To explore the current status and factors influencing the knowledge, attitudes, and practices (KAP) of orthopedic nurses toward the assessment and management of perioperative hidden blood loss (HBL). Perioperative HBL can significantly affect postoperative recovery in orthopedic patients. Although the effective management of HBL is crucial in clinical settings, related nursing practices and systematic training are insufficient in many healthcare institutions. Understanding the KAP of nurses in this field is essential for improving patient care outcomes. Cross-sectional, multicenter study. Convenience sampling was used to survey orthopedic nurses from 40 hospitals across 10 provinces in China between June 1 and September 30, 2023 using an online questionnaire. A total of 456 valid questionnaires were included. Mean scores of nurses’ KAP toward the assessment and management of perioperative HBL were 120.16 (30.85), 50.63 (9.59), and 40.17 (9.33), respectively, and corresponding scoring rates were 75.10%, 77.89%, and 73.03%, respectively, indicating moderate levels. Knowledge was positively correlated with practice (r = 0.608, p < 0.05), indicating that nurses with higher levels of knowledge tended to demonstrate better HBL-related clinical practices. Attitude showed a weak negative correlation with practice (r = − 0.118, p < 0.01), indicating that higher attitude scores were associated with slightly lower practice scores. No significant correlation was observed between knowledge and attitude (r = − 0.075, p > 0.05). Key influencing factors included work experience, hospital level, professional title, highest educational attainment, and participation in specialized training in orthopedic nursing. Collectively, these variables influenced the KAP of nurses on perioperative HBL. The KAP of orthopedic nurses in China regarding the assessment and management of perioperative HBL were moderate, indicating the need for further improvement through structured education and professional development.