Comparative assessment of nurses’ knowledge and practice on medical device-related pressure injury management in India and Europe: a cross-sectional study

The challenge of applying knowledge of Medical Device Related Pressure Injuries (MDRPIs) to clinical practice persists worldwide. This study examined the Knowledge, Attitude, and Practice (KAP) of nurses dealing with MDRPIs in two disparate organizational ecosystems, India and Europe. This was done to better understand the systemic factors that contribute to gaps in nursing competency as a result of disparate organizational ecosystems. The study used a 20-point validated KAP scale with a sample of 334 registered nurses located in Europe and in India. Gaps within the KAP scale were analyzed through domain-specific disparities with demographic variables as covariates. Nurses in Europe scored substantially higher on the KAP scale (17.61 ± 2.14) compared to the Indian nurses (10.94 ± 2.85; p < 0.005). The largest gap was in Clinical Practice (2.64 ± 1.44 vs. 5.30 ± 1.03; p < 0.005). Subgroup analyses showed that the performance gaps were unrelated to the demographic variables in question. Interestingly, the Indian cohort had a higher percentage of postgraduate nurses, thus indicating that higher levels of education do not necessarily correlate to higher levels of Clinical Practice. The management of MDRPIs is a product of the nursing environment as determined by the organizational structures of the health system, rather than the capability of the individual nurse. Closing the gap in competency requires movement away from higher levels of Academic Qualifications, and a concentration on the nursing Clinical Environment through the development and standardization of institutional clinical protocols.