Knowledge, Perceptions and Practices of Midwives in the Prevention of Pressure Injuries in Neonatal Critical Care Units
DOI:
https://doi.org/10.56294/saludcyt20251063Keywords:
Neonates, knowledge, Pressure Injuries, Prevention, NCCUAbstract
Introduction: pressure injuries (PI) in critically ill neonates are a health problem with a negative impact on morbidity, mortality, and healthcare costs. Knowledge and management of PI prevention by healthcare professionals are crucial for improving clinical practice.
Objective: to analyze the level of knowledge, perceptions, and practices of midwives in Neonatal Critical Care Units (NCCU) regarding PI prevention.
Material and Methods: a quantitative, descriptive, non-experimental, cross-sectional study with a sample of 32 midwives from three NCCUs in the Fifth Region of Chile. The validated PREVINTLPP questionnaire was used.
Results: knowledge of PI prevention was insufficient (average 64,8 % minimum 70 % to be considered adequate), with great variability in responses. Adherence to recommended clinical practice was even lower (43,5 % on average). There is awareness that PIs are a quality indicator, but 96,9 % are unaware of international guidelines for their management.
Conclusions: Knowledge of PI prevention in the study sample is inadequate, possibly due to poor knowledge management. Further investigation into the causes and implementation of specialized training programs are needed to improve the quality of care and patient safety.
References
María S, Brotons-Payá C. Neonatal pressure ulcers: Prevention and treatment. Enferm Clin. 2017;27(1):29-40. DOI: https://doi.org/10.2147/RRN.S98755
National Pressure Ulcer Advisory Panel (NPUAP), European Pressure Ulcer Advisory Panel (EPUAP), and Pan Pacific Pressure Injury Alliance (PPPIA). Prevention and treatment of pressure ulcers: Clinical practice guideline. www.npuap.org. 2014.
García-Molina P, Balaguer-López E, García-Fernández FP, Ferrera-Fernández MÁ de los Á, Blasco JM, Verdú J. Pressure ulcers’ incidence, preventive measures, and risk factors in neonatal intensive care and intermediate care units. Int Wound J. 2018;15(6):933-40. DOI: https://doi.org/10.1111/iwj.12900
National Institute for Health and Care Excellence. Pressure ulcers in adults: prevention and management. NICE guideline [NG179]. 2020;(April):1–11. Disponible en: http://pathways.nice.org.uk/pathways/pressure-ulcers
Lucchini A, Elli S, Bianchi F, Birleanu, Zucchini S, Ceccarelli S, Bambi S. Incidence and risk factors associated with the development of pressure ulcers in an Italian general intensive care unit. Assist Inferm Ric. 2018;37(4):181-8.
McEvoy N, Avsar P, Patton D, Curley G, Kearney CJ, Moore Z. The economic impact of pressure ulcers among patients in intensive care units. A systematic review. J Tissue Viability. 2021;30(2):168-77. DOI: https://doi.org/10.1016/j.jtv.2020.12.004
National Clinical Guideline Centre (UK). Pressure ulcer prevention. National Institute for Health and Care Excellence; 2014. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK333117/
Albarqouni L, Hoffmann T, Straus S, Olsen NR, Young T, Ilic D, et al. Core Competencies in Evidence-Based Practice for Health Professionals: Consensus Statement Based on a Systematic Review and Delphi Survey. JAMA Netw Open. 2018;1(2):e180281. DOI: https://doi.org/10.1001/jamanetworkopen.2018.0281
Sandars J, Heller R. Improving the implementation of evidence-based practice. J Eval Clin Pract. 2006;12(4):341-6. DOI: https://doi.org/10.1111/j.1365-2753.2006.00534.x
Ayatollahi H, Zeraatkar K. Factors influencing the success of knowledge management process in health care organisations: A literature review. Health Info Libr J. 2020;37(2):98-117. DOI: https://doi.org/10.1111/hir.12285
De Meyer D, Verhaeghe S, Van Hecke A, Beeckman D. 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;28(2):59-69. DOI: https://doi.org/10.1016/j.jtv.2019.03.002
Fulbrook P, Lawrence P, Miles S. Australian Nurses’ Knowledge of Pressure Injury Prevention and Management: A Cross-sectional Survey. J Wound Ostomy Continence Nurs. 2019;46(2):106-12. DOI: https://doi.org/10.1097/WON.0000000000000508
Tirgari B, Mirshekari L, Forouzi MA. Pressure Injury Prevention: Knowledge and Attitudes of Iranian Intensive Care Nurses. Adv Skin Wound Care. 2018;31(4):1-8. DOI: https://doi.org/10.1097/01.ASW.0000530848.50085.ef
Galvão NS, Serique MAB, Santos VLCG, Nogueira PC. Knowledge of the nursing team on pressure ulcer prevention. Rev Bras Enferm. 2017;70(2):294-300. DOI: https://doi.org/10.1590/0034-7167-2016-0063
Halász BG, Bérešová A, Tkáčová L, Magurová D, Lizáková L. Nurses’ knowledge and attitudes towards prevention of pressure ulcers. Int J Environ Res Public Health. 2021;18(4):1-9. DOI: https://doi.org/10.3390/ijerph18041705
Sengul T, Karadag A. Determination of nurses’ level of knowledge on the prevention of pressure ulcers: The case of Turkey. J Tissue Viability. 2020;29(4):337-41. DOI: https://doi.org/10.1016/j.jtv.2020.06.005
Jiang L, Li L, Lommel L. Nurses’ knowledge, attitudes, and behaviours related to pressure injury prevention: A large-scale cross-sectional survey in mainland China. J Clin Nurs. 2020;29(17-18):3311-24. DOI: https://doi.org/10.1111/jocn.15358
Garza Hernández R, Meléndez Méndez MC, Fang Huerta MÁ de los Á, González Salinas JF, Castañeda-Hidalgo H, Argumedo Pérez NE. Conocimiento, actitud y barreras en enfermeras hacia las medidas de prevención de úlceras por presión. Cienc Enferm. 2017;23(3):47-58. DOI: https://doi.org/10.4067/S0717-95532017000300047
Rodríguez JEC, Gamboa SG. Prevención de lesiones por presión: conocimientos y actitudes del personal de enfermería. J Wound Care. 2020;29(Sup10):6-15. DOI: https://doi.org/10.12968/jowc.2020.29.Sup10.6
Dalvand S, Ebadi A, Gheshlagh RG. Nurses’ knowledge on pressure injury prevention: A systematic review and meta-analysis based on the pressure ulcer knowledge assessment tool. Clin Cosmet Investig Dermatol. 2018;11:613-20. DOI: https://doi.org/10.2147/CCID.S186381
Santos SV, Costa R. Prevention of newborn skin lesions: Knowledge of the nursing team. Texto Contexto Enferm. 2015;24(3):731-9. DOI: https://doi.org/10.1590/0104-07072015011230014
Karltun A, Sanne JM, Aase K, Anderson JE, Fernandes A, Fulop NJ, et al. Knowledge management infrastructure to support quality improvement: A qualitative study of maternity services in four European hospitals. Health Policy (New York). 2020;124(2):205–15. DOI: https://doi.org/10.1016/j.healthpol.2019.11.005
Hommel A, Gunningberg L, Idvall E, Bååth C. Successful factors to prevent pressure ulcers - an interview study. J Clin Nurs. 2017;26(1-2):182-9. DOI: https://doi.org/10.1111/jocn.13465
Ferrera-Fernández MÁ. Análisis del grado de conocimiento de los enfermeros, sobre los cuidados para la prevención de las úlceras por presión, y su implementación, en los hospitales de Gran Canaria [tesis doctoral]. Universidad de Las Palmas de Gran Canaria; 2015. Disponible en: http://cris.ulpgc.es/jspui/handle/10553/21687.
Esperón Güimil JA, Vázquez Vizoso FL. Los conocimientos de las enfermeras sobre ulceras por presion y sus determinantes. Gerokomos. 2004;15(3):107-16.
Gaspar S, Peralta M, Marques A, Budri A, Gaspar de Matos M. Effectiveness on hospital-acquired pressure ulcers prevention: A systematic review. Int Wound J. 2019;16(5):1087-102. DOI: https://doi.org/10.1111/iwj.13147
Beeckman D, Vanderwee K, Demarré L, Paquay L, Van Hecke A, Defloor T. Pressure ulcer prevention: Development and psychometric validation of a knowledge assessment instrument. Int J Nurs Stud. 2010;47(4):399-410. DOI: https://doi.org/10.1016/j.ijnurstu.2009.08.010
Pancorbo Hidalgo PL, García Fernández FP, Rodríguez Torres MC, Torres García M, López Medina IM. Conocimientos y creencias de las enfermeras sobre el cuidado de las úlceras por presión: revision sistemática de la literatura. Gerokomos. 2007;18(4):199-208. DOI: https://doi.org/10.4321/S1134-928X2007000400005
Qaddumi J, Khawaldeh A. Pressure ulcer prevention knowledge among Jordanian nurses: A cross-sectional study. BMC Nurs. 2014;13(1):1-8. DOI: https://doi.org/10.1186/1472-6955-13-6
Sving E, Idvall E, Högberg H, Gunningberg L. Factors contributing to evidence-based pressure ulcer prevention. A cross-sectional study. Int J Nurs Stud. 2014;51(5):717-25. DOI: https://doi.org/10.1016/j.ijnurstu.2013.09.007
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Jonathan Galvez-Arancibia, Cristian Carreño-León, Alicia Infante Peñafiel, Mabel Araya Novoa, Felipe Retamal-Walter (Author)

This work is licensed under a Creative Commons Attribution 4.0 International License.
The article is distributed under the Creative Commons Attribution 4.0 License. Unless otherwise stated, associated published material is distributed under the same licence.
