An Online Mixed-Methods Study Assessing Nurses’ Training, Attitudes, Knowledge, Skill/Ability, and Perceived Barriers With Regard to Adherence to the National Pressure Ulcer Advisory Panel’s Clinical Practice Guidelines

The problem this study addresses is the need for nurses to adhere to guidelines on pressure ulcer prevention and treatment, so patients best possible health outcomes. This study created and utilized a new tool to assess nurses’ training, attitudes, knowledge, and skill/ability for adhering to practice guidelines of the National Pressure Ulcer Advisory Panel. The study sought to identity significant predictors of Personal Knowledge Rating Scale (TPKRS-101) and Personal Skill/Ability Rating Scale (TPS/ARS-101). The online study’s convenience sample of nurses (n=190) was 80.5% (n=153) female, 59.5% (n=113) Black, and 18.4% (n=35) Asian—with mean age of 40.27 years (min 23, max 73, SD=10.95). Some 53.2% (n=101) were not born in the US, while 16.8% (n=32) were from Ghana, 7.9% (n=15) from Jamaica, and 7.4% (n=14) from Philippines. Annual household income mean was $50,000 to $99,999 (mean=4.43, category 4, min=2, max=10, SD=1.00). Mean years working in nursing was 8-10 years (mean=4.34, category 4, min=1, max=9, SD=2.14). Nurses rated themselves “good” for performing pressure ulcer care tasks, as follows: (a) Nursing Training Rating Scale (TNRS-101) with global mean of 4.11 (SD=0.60, min= 1.94, max=5.00), or good; (b) Personal Knowledge Rating Scale (TPKRS-101) with global mean of 4.15 (SD=0.57, min=2.79, max=5.00), or good; and, (c) Personal Skill/Ability Rating Scale (TPS/ARS-101) with global mean of 4.13 (SD=0.62, min=2.56, max=5.00), or good. Higher Personal Knowledge Rating Scale (TPKRS-101) scores were significantly predicted by: more positive Attitudes Regarding Practice Guidelines-Relevance Scale (ARPG-R-5) (b = .067, SEB = .029, p = .022); and, higher level of Social Desirability (13 items) (b = .030, SEB = .013, p =.023). For this regression model, R2=.063, and AdjR2=.053, meaning that 5.3% of the variance was explained by model. Personal Skill/Ability Rating Scale (TPS/ARS-101) scores were significantly predicted by: higher level of Social Desirability (13 items) (b = .051, SEB = .014, p = .000). For this regression model, R2=.064, and AdjR2=.059, meaning that 5.9% of the variance was explained by model. Finally, the quantitative data were augmented by qualitative findings for barriers nurses experience to pressure ulcer prevention and treatment, as follows: Category I-External Barriers; and, Category II-Internal Barriers.