Knowledge of pressure injury prevention and perceived barriers to applying it among nursing students at a tertiary institution in the United Arab Emirates: a mixed-methods study

Pressure injuries are largely preventable, yet their burden across acute care in the United Arab Emirates (UAE) and the Gulf region is substantial. It is unknown if pre-registration education in the UAE equips nursing students with the requisite knowledge. This study assessed nursing students’ knowledge of pressure injury prevention and the barriers they perceived to applying it in clinical practice. A concurrent, equal-status mixed-methods study was conducted among 133 nursing students in academic years 2–4 at a UAE health sciences college, using an adapted 31-item Pressure Injury Prevention Knowledge (PIPK) questionnaire and two open-ended questions on perceived barriers and suggested improvements. Descriptive statistics, Welch’s t-test, one-way and Welch ANOVA, chi-square/Fisher-Freeman-Halton tests, Pearson and Spearman correlations, and a multivariable linear regression were computed for the quantitative arm of the study. Barriers and strategies were analysed using qualitative content analysis. Participants (mean age 21.9 ± 1.9 years; 99.2% Emirati) scored 19.9 ± 5.2 of 31 (64.1% ± 16.6%); 20.3% met the pre-specified good-knowledge threshold (≥ 80%), 42.1% moderate (60–79%), and 37.6% poor (< 60%). Performance was markedly and significantly better on true-keyed than on false-keyed items (mean 79.7% vs. 40.5% correct; paired t = 18.96, p < 0.001, Cohen’s d = 1.65). Knowledge was weakly associated with year of study (Spearman ρ = 0.23–0.25, p < 0.01) and clinical placements completed (ρ = 0.22, p = 0.01), but in an adjusted multivariable model no individual predictor remained statistically significant (R² = 0.07, p = 0.09). There were six categories of barriers; poor training-practice linkage (54%), lack of time (51%), workforce-capacity constraints (43%), lack of equipment (26%), communication or documentation breakdown (13%) and patient-related complexity (12%). Suggested improvements included regular training (58.9%), simulation (35.7%) and updated guidelines (22.3%). Nursing students showed moderate knowledge of pressure injury prevention overall. Knowledge was associated with academic seniority. Barriers to applying the prevention knowledge included insufficient training/practice opportunities, time and workforce constraints. More training, simulation, and accessible guidelines that address these barriers are needed to improve knowledge of pressure injury prevention.