Nurses’ knowledge, attitudes, and practices in pressure ulcer prevention in intensive care units: associations with burnout

PeerJ. 2026 May 14;14:e21250. doi: 10.7717/peerj.21250. eCollection 2026.

ABSTRACT

BACKGROUND: Nurses play a crucial role in preventing pressure ulcers, as they are at the forefront of patient care and are responsible for implementing preventive measures. The current study aimed to explore nurses’ knowledge, attitudes, and practices regarding pressure ulcer (PU) prevention in Intensive Care Units (ICUs) and to identify any correlation between these variables and nurses’ burnout.

METHODS: This study was conducted in the intensive care units of Zagazig University Hospitals in Egypt, with data collection from January 2024 to May 2024. The study included 131 nurses working in these units. Data were collected using a self-administered questionnaire that included sociodemographic information, nurses’ knowledge, attitudes, and practices related to pressure ulcer prevention, and a burnout assessment tool.

RESULTS: Nurses exhibited moderate knowledge of pressure ulcer prevention (16.1 ± 4.6). Nurses demonstrated moderately favorable attitudes overall, with strong agreement on key prevention principles (e.g., the avoidability of PUs and the need for risk assessments), but perceived challenges with time and prioritization. However, adherence to recommended practices was low, with 54.8% of checklist items not completed. Additionally, these nurses experienced a notable level of burnout, particularly in cognitive and emotional domains (3.6 ± 0.8 and 3.6 ± 0.9, respectively). A significant, moderate positive correlation was found between nurses’ knowledge of pressure ulcer prevention and their practices (r = 0.353, p < 0.001).

CONCLUSION: ICU nurses demonstrated moderate knowledge and a relatively positive, moderate attitude toward pressure ulcer prevention. However, they also identified several potential obstacles to the effective implementation of preventive practices. ICU nurses experienced very high levels of burnout, particularly in cognitive and emotional domains. The knowledge and attitudes of ICU nurses concerning pressure ulcer prevention emerged as essential factors influencing their clinical practices.

PMID:42153147 | PMC:PMC13180348 | DOI:10.7717/peerj.21250