Conectar
Pressure ulcers (PUs) (also termed pressure injuries [PIs]) remain a major patient safety issue, particularly in critical care and other high-risk healthcare settings. Nurses are central to PUs/PIs prevention; however, deficiencies in knowledge, attitudes, and preventive practices among nursing staff may negatively affect patient outcomes. To systematically synthesise global evidence on nurses' knowledge, attitudes, and practices related to PUs/PIs prevention, and to identify factors influencing preventive performance. A systematic review was conducted in accordance with PRISMA guidelines. Electronic databases including PubMed, CINAHL, EBSCO, MEDLINE, PsycINFO, and Springer were searched for studies published between 2011 and 2025. Eligible studies were primary research articles examining registered nurses' knowledge, attitudes, and/or practices regarding PUs/PIs prevention, using cross-sectional, observational, or non-experimental designs. Data extraction focused on study characteristics, settings, samples, assessment instruments, and key outcomes related to knowledge, attitudes, and preventive practices. Due to methodological heterogeneity, a narrative synthesis was performed. Twenty-nine studies from diverse geographical regions were included, with sample sizes ranging from 28 to 950 nurses. Overall, nurses' knowledge of PUs/PIs prevention was frequently inadequate, particularly in prevention-specific domains. In contrast, attitudes toward prevention were generally positive across studies. Preventive practices, however, were often suboptimal. Commonly reported barriers included staff shortages, high workload, limited resources, and insufficient institutional support. Higher educational attainment, specialised clinical experience, recent training, and professional seniority were consistently associated with better knowledge, more positive attitudes, and improved preventive practices. Although nurses generally demonstrate positive attitudes toward PUs/PIs prevention, persistent gaps in knowledge and practice remain. These findings underscore the need for structured education programmes, simulation-based training, and strengthened organisational support to enhance adherence to evidence-based prevention strategies. Future research should employ experimental and longitudinal designs, standardised measurement tools, and broader international representation to support sustainable improvements in PUs/PIs prevention and patient safety.
Prospective cohort study
In this pilot study, we recruited patients from a secondary pain clinic in Boston, Massachusetts.
In this pilot study, we recruited patients from a secondary pain clinic within the Spaulding Rehabilitation network in Boston, Massachusetts, USA. We enrolled 37 patients who initially came in for a clinical visit with the principal investigator of the study. Of the 37 patients, 14 patients who continued to enrol/join after December 2024 received the ‘DigitalPulse’ to drive engagement.
To present a roadmap for our efforts to contextualise engagement in our digital health technology study and showcase our attempts to incorporate an engagement approach inspired by the Method for Program Adaptation through Community Engagement. Building on this, we further incorporated continued feedback and revision beyond the prototype of the user-centred feedback form (‘DigitalPulse’) to include expanded stakeholders such as clinicians and research assistants.
From these patients, we observed that our approach produced highly variable changes in engagement with slight increases at the group level.
From our observations, we have found that it is important to incorporate iterative refinements and expanded stakeholder involvement in designing patient-centred digital health tools to improve engagement. Overall, we report a process to address engagement and emphasise the need for continuous personalisation in digital health interventions.
FreshRSS 