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Medical device-related pressure injuries (MDRPIs) are a patient safety concern in acute and critical care settings. Registered nurses must implement preventive strategies, yet gaps remain in their knowledge, attitudes, and clinical practices related to MDRPI prevention. This study aimed to evaluate the effectiveness of a structured educational intervention in improving registered nurses' knowledge, attitudes, and practices related to MDRPI prevention. A quasi-experimental pre–post intervention study was conducted in a tertiary care hospital in Saudi Arabia, with 311 registered nurses participating. Data were collected using a questionnaire assessing knowledge, attitudes, and practices related to MDRPI prevention. Participants received a one-day structured educational program based on the knowledge, attitude, practice (KAP) framework and the evidence-based SKINCARE bundle. The educational intervention resulted in significant improvements. Mean scores increased from 14.17 (SD = 2.38) pre-intervention to 16.25 (SD = 1.97) post-intervention (t = −11.81, p < 0.001). The intervention demonstrated a moderate-to-large effect size (Cohen's d = 0.67), indicating meaningful improvement in nurses' preventive competencies. Structured educational programs can enhance registered nurses' knowledge and practices in MDRPI prevention. Integrating evidence-based training programs into routine hospital education may strengthen pressure injury prevention guidelines and improve patient safety outcomes.
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.
This scoping review aims to explore the existing research on the impact of authentic leadership on nurses' innovative behaviours.
The following databases were searched (from 2013 to 2023): PubMed, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Embase, Scopus, APA Psych Info, Educational Resources Information Centre, and ABI Inform.
Search results were exported into Covidence software to assist with the selection and assessment of retrieved studies. Studies were included that specifically examined the relationship between authentic leadership and innovative behaviour among nurses working in healthcare settings.
12 papers remained for full-text review after title and abstract screening. Four studies that met the inclusion criteria were included in the final analysis. Using the Crowe Critical Appraisal Tool two reviewers independently evaluated these four studies. Findings revealed that authentic leadership affects nurses' innovation and creativity in various healthcare settings and cultural contexts. It also highlighted mediating factors such as increased engagement and knowledge sharing. Resilience and technological infrastructure were identified as additional factors that affect and support this relationship and influence the development and enaction of innovative behaviours.
Authentic leadership was found to contribute to innovative nursing behaviours that have important implications for the best practices in healthcare and outcomes.
Innovative behaviour among nurses is essential for rising to the challenges of complex healthcare environmental challenges, and the potential for authentic leadership to act as a catalyst for this is important. Future research needs to further explore the impact of authentic leadership on innovative behaviour and the contextual and cultural influences that effect this. More research is also needed on the exact nature of nurses' innovations and their potential use in healthcare.
The EQUATOR guidelines for PRISMA have been met.
No patient or public contribution.
To compare in-hospital and long-term outcomes between culprit-only percutaneous coronary intervention (PCI) and multivessel PCI in patients with acute myocardial infarction complicated by cardiogenic shock and multivessel coronary artery disease.
Retrospective subgroup analysis of the multicentre Gulf-Cardiogenic Shock registry.
13 tertiary care centres across six Gulf countries (Saudi Arabia, Qatar, Oman, UAE, Kuwait and Bahrain) between January 2020 and December 2022.
961 patients with angiographically confirmed multivessel coronary artery disease who underwent PCI were included from the Gulf-Cardiogenic Shock registry. Patients were divided into culprit-only PCI group (n=792, 82.4%) and multivessel PCI group (n=169, 17.6%). Patients with single-vessel disease were excluded.
Patients underwent either culprit-only PCI (intervention limited to the culprit artery) or multivessel PCI (immediate intervention to both culprit and non-culprit arteries during the same procedure).
The primary outcome was in-hospital all-cause mortality. Secondary outcomes included reinfarction, cerebrovascular accident, major and minor bleeding events, target lesion revascularisation, target vessel revascularisation, hospital stay duration and freedom from major adverse cardiac and cerebrovascular events (MACCEs) at 6 and 12 months.
Hospital mortality was comparable between multivessel PCI and culprit-only PCI groups (43.2% vs 46.1%; p=0.493). Freedom from MACCE rates at 6 and 12 months were 62% and 46% for multivessel PCI versus 70% and 49% for culprit-only PCI, respectively (log-rank p=0.711). Subgroup analysis revealed that culprit-only PCI was associated with increased hospital mortality in patients older than 70 years (OR 1.55, 95% CI: 1.01 to 2.39). Multivariable analysis of the interaction between revascularisation strategy and the subgroups revealed that culprit vessel revascularisation was associated with increased mortality in patients with left main disease (OR: 1.99 (95% CI: 1.22 to 3.27), p=0.006) and left anterior descending lesions (OR: 1.54 (95% CI: 1.06 to 2.25), p=0.025).
No statistically significant differences in hospital mortality or long-term MACCE-free survival were observed between culprit-only PCI and multivessel PCI strategies in patients with cardiogenic shock complicating acute myocardial infarction. However, patients older than 70 years may benefit from a multivessel PCI approach. These findings support current guideline recommendations favouring culprit-only PCI due to reduced procedural complexity while highlighting the need for individualised treatment strategies based on patient age and clinical factors. Further prospective randomised studies are needed to validate these age-specific findings and identify optimal patient selection criteria for each revascularisation strategy.
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