Knowledge of nurses and nursing assistants about pressure ulcer prevention: A survey in 16 Belgian hospitals using the PUKAT 2.0 tool

J Tissue Viability. 2019 May;28(2):59-69. doi: 10.1016/j.jtv.2019.03.002. Epub 2019 Mar 27.


Background: Pressure ulcers have a high impact on patients and their families. Profound and up-to-date knowledge among nurses is important given the effect on attitudes and preventative behaviour. To gain insight into educational needs and priorities, regular knowledge assessments are needed.

Objective: To gain insight into the knowledge of nurses and nursing assistants about pressure ulcer prevention.

Design: Cross-sectional multicentre study.

Methods: 474 nurses and nursing assistants recruited at 29 wards in 16 hospitals completed individually the PUKAT 2.0, a valid and reliable questionnaire to measure nurses knowledge about pressure ulcer prevention. Data were collected between February 2016 and December 2017. Independent sample t-tests, one-way analyses of variance and Kruskal-wallis tests were performed to analyse the results.

Results: The mean total score was 50.7%. The lowest scores were found in the themes knowledge about prevention (42.7%), aetiology (45.6%) and prevention for specific patient groups (46.6%). Higher educational level (H = 40.43, p < 0.001) and attending additional training about pressure ulcers or wound care in general (t = 2.93, p = 0.004) resulted in significant higher total knowledge scores.

Conclusion: The results of this study highlight an important knowledge deficit about pressure ulcer prevention. The PUKAT 2.0 knowledge assessment tool made it possible to differentiate between a variety of cognitive process levels. This allowed to identify knowledge gaps and focus areas for continuing professional education. Education curricula for nurses and associated healthcare professionals are to be screened thoroughly and the identified knowledge gaps should be covered. Besides, multifaceted strategies are needed to improve clinical practice.

Keywords: Assessment; Instrument; Knowledge; Nursing; Practice; Pressure ulcer; Prevention.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Belgium
  • Clinical Competence / standards*
  • Cross-Sectional Studies
  • Educational Measurement / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nurses / standards*
  • Nurses / statistics & numerical data
  • Pressure Ulcer / physiopathology
  • Pressure Ulcer / prevention & control*
  • Pressure Ulcer / therapy
  • Statistics, Nonparametric
  • Surveys and Questionnaires