Pressure injuries (PIs) pose a significant challenge in intensive care units (ICUs) globally. This article examines the knowledge of South African ICU nurses regarding PI prevention using the Pressure Ulcer Knowledge Assessment Tool (PUKAT 2.0), providing insights into areas where knowledge gaps exist and highlighting the need for targeted training and educational interventions.
Assessing Critical Care Nursing Knowledge of Pressure Injury Prevention
A descriptive cross-sectional study was conducted at an academic hospital in Gauteng Province, South Africa, involving 101 ICU nurses. The PUKAT 2.0, a validated instrument designed to assess knowledge of PI prevention, was used to gather data. The questionnaire covered topics such as etiology, classification, risk assessment, nutrition, prevention measures, and specific patient groups.
Fig. 1. Structure and scoring of the PUKAT 2.0 questionnaire used in the study.
Key Findings on Pressure Injury Prevention Knowledge
The study revealed a mean knowledge score of 42.16% (SD 12.09), significantly below the 60% benchmark indicating adequate knowledge. Notably, only 5.9% of participants achieved a score of 60% or higher. The lowest scores were observed in the “prevention of pressure injuries” (25%) and “classification and observation” (39.5%) sections. “Risk assessment” (100%) and “nutrition” (50%) had the highest scores.
Fig. 2. Distribution of scores on the PUKAT 2.0, showing the percentage of participants who scored 60% or higher and those who scored below 59%.
Factors Influencing Knowledge Levels in Critical Care
Statistical analysis indicated a correlation between higher education levels and improved PUKAT 2.0 scores. Nurses with postgraduate qualifications, especially Master’s degrees, demonstrated significantly better knowledge. Experience also played a role, with nurses having 2-5 years of experience outperforming those with 6-10 years. Younger nurses (20-29 years) also tended to score higher.
Fig. 3. Factors associated with knowledge of pressure injury prevention, showing the odds ratios for different demographic variables.
Implications for Critical Care Nursing Practice
These findings highlight a critical need for improved PI prevention education and training for ICU nurses in South Africa. Targeted interventions focusing on “prevention of pressure injuries” and “classification and observation” are crucial. Continuous professional development programs are essential, particularly for nurses with less experience or lower educational qualifications, ensuring they remain updated with the latest evidence-based practices.
Conclusion: Addressing Knowledge Gaps in Pressure Injury Prevention
This study underscores the importance of addressing knowledge gaps in PI prevention among critical care nurses. The findings provide a foundation for developing tailored educational strategies and resource allocation to improve patient outcomes in the South African healthcare context. Further research is needed to evaluate the effectiveness of such interventions and their long-term impact on PI rates in ICUs.
