NURSES KNOWLEDGE, ATTITUDES AND PRACTICES REGARDING PRESSURE ULCER PREVENTION IN TERTIARY CARE HOSPITALS OF KARACHI: A CROSS-SECTIONAL STUDY

Abstract

Background: Pressure ulcers (PUs), also known as bedsores or decubitus ulcers, represent one of the most common and preventable complications in hospitalized patients worldwide.¹ They occur when localized soft tissue is compressed between a bony prominence and an external surface for a prolonged period, leading to ischemia, tissue necrosis, and potential infection.² Pressure ulcers are associated with significant negative outcomes, including severe pain, prolonged hospitalization, delayed rehabilitation, increased healthcare costs, reduced quality of life, and even death.³

Pressure ulcers remain a major healthcare challenge worldwide, particularly in developing countries such as Pakistan, where limited awareness, inadequate staffing, lack of standardized prevention protocols, and insufficient training opportunities contribute to their occurrence. Nurses, as frontline healthcare providers, play a vital role in preventing pressure ulcers through risk assessment, regular patient repositioning, skin inspection, nutritional support, moisture management, and patient education. However, the success of these preventive measures largely depends on nurses’ knowledge, attitudes, and clinical practices. Previous studies have reported inadequate knowledge, variable attitudes, and inconsistent adherence to evidence-based prevention guidelines among nurses. Therefore, assessing nurses’ knowledge, attitudes, practices, and perceived barriers regarding pressure ulcer prevention in tertiary care hospitals is essential to identify existing gaps and develop targeted strategies to improve patient outcomes and quality of care.⁴⁻¹⁰

This study aims to assess the knowledge, attitudes, and practices of nurses regarding pressure ulcer prevention in tertiary care hospitals in Karachi, Pakistan, and to identify barriers that hinder effective prevention. A cross-sectional quantitative study design will be used. Data will be collected from registered nurses working in tertiary care hospitals using structured questionnaires, including the Pressure Ulcer Knowledge Assessment Tool (PUKAT 2.0) for knowledge, the Attitude towards Pressure Ulcer Prevention (APuP) scale for attitudes, and a self-reported practice and barriers questionnaire. The findings of this study will provide comprehensive baseline data on nurses' knowledge, attitudes, practices, and perceived barriers, which can be used to develop targeted educational interventions and organizational support strategies to improve patient safety and reduce the incidence of hospital-acquired pressure ulcers in Pakistan.