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Attitude and adherence to evidence-based pressure injury prevention practices of neonatal intensive care nurses in China: a cross-sectional study

Year: 2025

Type: article

Abstract: AIM: To explore neonatal intensive care unit (NICU) nurses' attitude, adherence, and influencing factors to pressure injury (PI) prevention based on guidelines, and identify the relationship between the attitude and adherence. METHODS: A multi-site, quantitative, cross-sectional study spanning 16 provinces in China was conducted. Data were collected by a self-reported questionnaire, including three sections: demographic information, attitude towards PI prevention, and adherence to evidence-based PI prevention. The sample size was calculated using PASS 2025, and a convenience sampling method was conducted. The data were analyzed using SPSS 27, and univariate analysis and multiple logistic regression were employed to examine the relationship between demographic data and attitude and adherence to the PI prevention. Besides, the relationship between the APuP and the adherence was shown through the structural equation model (SEM), it was estimated in Amos 24.0. RESULTS: In total, 465 NICU nurses were included in this survey. The NICU nurses' mean score of attitudes toward PI prevention was 78.06 %, with the highest mean score in the subscale of responsibility in PI prevention (85 %). The mean score of the PI prevention compliance was 132.93 ± 15.21, with a scoring rate of 88.62 %. The highest mean score was in the "skin assessment and care" subscale (41.51 ± 4.47, 92.24 %), followed by the "repositioning and mobilization" domain (22.92 ± 2.64, 91.68 %), and "medical device" domain (27.33 ± 3.29, 91.1 %). The nurses who had been trained in the PI prevention guideline were found to have 1.822 times the PI prevention attitude ≥75 % than those who did not undergo training (P = 0.008). In addition, clinical nurse specialist (CNS) were 1.684 times in the PI prevention practice adherence ≥90 % than those who were not (P = 0.028). The attitude towards PI prevention was determined to affect the adherence in the NICUs directly (β = 1.521, P < 0.001), and a positive association was detected between attitude scores and adherence scores. CONCLUSION: The level of attitude and the adherence of NICU nurses in China related to PI prevention were relatively desirable and poor, and a positive relationship was shown between the attitude and adherence.

Source: Journal of Tissue Viability

DOI: 10.1016/j.jtv.2025.100976