Investigation of Nursing Students' Knowledge, Attitudes, and Awareness Regarding the Prevention of Perioperative Pressure Injuries

Abstract

Aim: This study aims to determine nursing students’ levels of knowledge, attitudes, and awareness regarding the prevention of surgery-related pressure injuries and to examine the relationship among these three variables. Materials and Methods: This descriptive and cross-sectional study was conducted during the Spring semester of the 2024–2025 academic year at the Faculty of Health Sciences, Department of Nursing, Burdur Mehmet Akif Ersoy University. Of the 320 third- and fourth-year nursing students who constituted the study population, 260 students were included. Data were collected using the Student Information Form, the Pressure Ulcer Prevention Knowledge Assessment Instrument – Turkish Version, the Attitude Toward Pressure Ulcer Prevention Scale and the Surgery-Related Pressure Injury Awareness Form. Descriptive statistics and Pearson correlation test were used for data analysis (p<0.05). Results: The participants had a mean age of 22.1±1.1 years, and 71.1% were female. A total of 59.2 % of the students reported having no direct experience in pressure injury care. The mean knowledge score was 42.5±2.7; the mean attitude score was 21.9±3.6; and the mean awareness score was 19.5±2.5. No statistically significant relationships were found between the variables (p>0.05). Conclusion: Nursing students were found to have insufficient knowledge, moderately positive attitudes, and limited awareness regarding the prevention of surgery-related pressure injuries. These findings highlight the need for structured and practice-oriented education programs that integrate theoretical knowledge with clinical application in nursing curricula. Educational content should be revised in line with current guidelines and supported by strategies that enhance clinical experience.

Keywords

• Nursing Student
• Perioperative Care
• Pressure Injury
• Surgery

Hemşirelik Öğrencilerinin Cerrahiye Bağlı Basınç Yaralanmalarının Önlenmesine Yönelik Bilgi, Tutum ve Farkındalıklarının İncelenmesi

Abstract

Amaç: Bu çalışma, hemşirelik öğrencilerinin cerrahiye bağlı basınç yaralarının önlenmesine yönelik bilgi, tutum ve farkındalık düzeylerini belirlemeyi ve bu üç değişken arasındaki ilişkiyi incelemeyi amaçlamaktadır. Gereç ve Yöntem: Tanımlayıcı ve kesitsel tasarımdaki bu çalışma, 2024–2025 Bahar döneminde Burdur Mehmet Akif Ersoy Üniversitesi Sağlık Bilimleri Fakültesi Hemşirelik Bölümü’nde gerçekleştirilmiştir. Evreni oluşturan 320 üçüncü ve dördüncü sınıf öğrencisinin 260’ı çalışmaya dahil edilmiştir. Veriler; Öğrenci Bilgi Formu, Basınç Ülseri Önleme Bilgi Değerlendirme Aracı, Basınç Ülseri Önlemeye Yönelik Tutum Ölçeği ve Cerrahiye Bağlı Basınç Yaralanması Farkındalık Formu aracılığıyla toplanmıştır. Verilerin analizinde tanımlayıcı istatistikler ve Pearson korelasyon testi kullanılmıştır (p<0,05). Bulgular: Katılımcıların yaş ortalaması 22,1±1,1 olup, %71,1’i kadındır. Öğrencilerin %59,2’i bası yarası bakımına yönelik doğrudan deneyim sahibi değildir. Bilgi puanı ortalaması: 42,5±2,7; Tutum puanı ortalaması: 21,9±3,6 ve Farkındalık puanı ortalaması: 19,5 ±2,5 dur. Değişkenler arasında istatistiksel olarak anlamlı bir ilişki saptanmamıştır (p>0,05). Sonuç: Hemşirelik öğrencilerinin cerrahiye bağlı basınç yaralarını önlemeye ilişkin bilgi düzeyleri yetersiz, tutumları orta düzeyde olumlu ve farkındalıkları sınırlı bulunmuştur. Bu durum, hemşirelik müfredatında teori-uygulama bütünlüğünü sağlayacak, yapılandırılmış ve uygulamaya dayalı eğitimlerin gerekliliğini ortaya koymaktadır. Eğitim içerikleri, güncel rehberlere uygun şekilde yeniden düzenlenmeli ve klinik deneyimi artırıcı stratejilerle desteklenmelidir.

Keywords

• Perioperatif bakım
• Hemşirelik öğrencisi
• basınç yaralanması
• Cerrahi

References

1. Tomas N, Mandume AM. Nurses’ barriers to the pressure ulcer risk assessment scales implementation: a phenomenological study. Nurs Open. 2024 Jan;11(1):e2079.
2. Weng PW, Chang WP. Extrinsic factors of pressure injuries in patients during surgery: a frequency matched retrospective study. Int Wound J. 2023 Aug;20(6):1934–42.
3. Zou Z, Lv S, Gao Q, Zhou X, Mao J. Operating room nurses’ awareness and implementation status of the prevention of patients’ intraoperative-acquired pressure injuries: design and validation of a questionnaire. Front Surg. 2023;10:1308181.
4. Shi G, Jiang L, Liu P, Xu X, Wu Q, Zhang P. Using a decision tree approach to analyze key factors influencing intraoperative-acquired pressure injury. Adv Skin Wound Care. 2023;36(11).
5. Ma LY, Chen HL, Gu HY, Hua L, Gao XM. Analysis of the clinical features and risk factors of device-related pressure injuries in the operating room. Int Wound J. 2023 Mar;20(3):706–15.
6. Falk-Brynhildsen K, Raepsaet C, Wistrand C, Bååth C, Leo Swenne C, Gifford M, et al. Swedish translation, cultural adaptation and psychometric evaluation of the pressure ulcer knowledge assessment tool for use in the operating room. Int Wound J. 2023 May;20(5):1534–43.
7. Celik B, Karayurt Ö, Ogce F. The effect of selected risk factors on perioperative pressure injury development. AORN J. 2019 Jul;110(1):29–38.
8. Savcı A, Karacabay K, Aydın E. Incidence and risk factors of operating room-acquired pressure injury: a cross-sectional study. Wound Manag Prev. 2024 Jun;70(2).

9. Spruce L. Prevention of perioperative pressure injury. AORN J. 2023 May;117(5):317–23.
10. Spruce L. Back to basics: preventing perioperative pressure injuries. AORN J. 2017 Jan;105(1):92–9.
11. Cukljek S, Rezic S, Ficko SL, Hosnjak AM, Smrekar M, Ljubas A. Croatian nurses’ and nursing students’ knowledge about pressure injury prevention. J Tissue Viability. 2022;31(3):453–8.
12. Yoltay HE, Özşaker E. Pressure injury knowledge and attitudes of senior nursing students. Adv Skin Wound Care. 2024;37(1).
13. Barakat-Johnson M, Lai M, Wand T, White K. A qualitative study of the thoughts and experiences of hospital nurses providing pressure injury prevention and management. Collegian. 2019;26(1):95–102.
14. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale (NJ): Lawrence Erlbaum Associates; 1988.
15. Tian J, Liang XL, Wang HY, Peng SH, Cao J, Liu S, et al. Nurses’ and nursing students’ knowledge and attitudes to pressure injury prevention: a meta-analysis based on APUP and PUKAT. Nurse Educ Today. 2023 Sep;128:105885.
16. Dag Sucu G, Firat Kilic H. Knowledge and attitudes of Turkish nursing students towards pressure injury prevention. J Tissue Viability. 2022;31(1):16–23.
17. Beeckman D, Vanderwee K, Demarré L, Paquay L, Van Hecke A, Defloor T. Pressure ulcer prevention: development and psychometric validation of a knowledge assessment instrument. Int J Nurs Stud. 2010;47(4):399–410.
18. Tulek Z, Polat C, Ozkan I, Theofanidis D, Togrol RE. Validity and reliability of the Turkish version of the pressure ulcer prevention knowledge assessment instrument. J Tissue Viability. 2016;25(4):201–8.
19. Beeckman D, Defloor T, Demarré L, Van Hecke A, Vanderwee K. Pressure ulcers: development and psychometric evaluation of the attitude towards pressure ulcer prevention instrument (APuP). Int J Nurs Stud. 2010;47(11):1432–41.
20. Üstün Y. Basınç ülserlerini önlemeye yönelik tutum ölçeğinin Türkçeye uyarlanması, geçerlik ve güvenirliğinin incelenmesi [Yüksek Lisans Tezi]. İzmir: Ege Üniversitesi Sağlık Bilimleri Enstitüsü; 2013.
21. Cebeci F, Şenol Çelik S. Knowledge and practices of operating room nurses in the prevention of pressure injuries. J Tissue Viability. 2022 Feb;31(1):38–45.
22. Celik B, Turhan Damar H, Savsar A, Ferraiuolo F, Repustic M, Ogce Aktas F. Investigation of related factors of operating room nurses’ attitudes and awareness towards surgery-related pressure injury prevention in Turkey, Croatia, and Italy. J Tissue Viability. 2024;33(3):418–24.
23. Westfall PH, Henning KSS. Understanding advanced statistical methods. Vol. 543. Boca Raton (FL): CRC Press; 2013.
24. World Health Organization. State of the world’s nursing report – 2020. Geneva: World Health Organization; 2020 Erişim Tarihi: 08.12.2024 Available from: https://www.who.int/china/news/detail/07-04-2020-world-health-day-2020-year-of-the-nurse-and-midwife
25. Rafiei H, Mehralian H, Abdar ME, Madadkar T. Pressure ulcers: how much do nursing students really know? Br J Nurs. 2015 Mar;24(6):S12–7.
26. Gunningberg L, Mårtensson G, Mamhidir AG, Florin J, Muntlin Athlin Å, Bååth C. Pressure ulcer knowledge of registered nurses, assistant nurses and student nurses: a descriptive, comparative multicentre study in Sweden. Int Wound J. 2015 Aug;12(4):462–8.
27. Li Z, Lin F, Thalib L, Chaboyer W. Global prevalence and incidence of pressure injuries in hospitalised adult patients: a systematic review and meta-analysis. Int J Nurs Stud. 2020 May;105:103546.
28. Tubaishat A, Papanikolaou P, Anthony D, Habiballah L. Pressure ulcers prevalence in the acute care setting: a systematic review, 2000–2015. Clin Nurs Res. 2018 Jul;27(6):643–59.
29. Bahar A, Özgürbüz NE, Akın E. Student nurses’ knowledge levels and attitudes regarding pressure injury prevention. J Tissue Viability. 2024 Jul;31(4)
30. Abd Rashid N, Md Esa NH. Transforming nursing education: evaluating knowledge and practices in pressure ulcer prevention among undergraduate nursing students at the International Islamic University Malaysia (IIUM). Semarak Int J Public Health Prim Care. 2025;3(1):69–81.
31. Simonetti V, Comparcini D, Flacco ME, Di Giovanni P, Cicolini G. Nursing students’ knowledge and attitude on pressure ulcer prevention evidence-based guidelines: a multicenter cross-sectional study. Nurse Educ Today. 2015;35(4):573–9.
32. Ghobadi-Larimi Z, Takasi P, Hosseini SJ, Firooz M. A systematic review of nursing students’ knowledge and related factors towards pressure ulcer prevention. J Nurs Rep Clin Pract. 2023;1(1):23–9.
33. Arıburnu Ö, Korkmaz F. Nursing students’ perceptions and experiences in pressure injury risk assessment: a qualitative study. Nurse Educ Pract. 2024 Aug;79:104039.
34. Ursavaş FE, İşeri Ö. Effects of education about prevention of pressure ulcer on knowledge and attitudes of nursing students. J Tissue Viability. 2020;29(4):331–6.
35. Chami L, Boussaid O, Boussaid H, Serhani Y, Zerhane R, Janati-Idrissi R. Nursing students’ knowledge towards pressure injury prevention: a cross-sectional study in the north of Morocco. J Tissue Viability. 2023;32(2):248–54.