The mediating role of attitude towards preventing pressure injuries in the relationship between intensive care nurses' knowledge level and self-efficacy towards medical device-related pressure injuries

Medical devices frequently used in the Intensive Care Unit (ICU) for diagnostic and therapeutic purposes increase the risk of pressure injuries developing under or around parts of the body. It is well known that nurses play a critical role in preventing Medical Device-Related Pressure Injuries (MDRPIs) in ICU patients who are at high risk. The aim of this study is to examine the effect of ICU nurses' knowledge levels and attitudes towards MDRPIs on their overall self-efficacy in managing pressure injuries. This descriptive and cross-sectional study was conducted with 302 nurses working in the internal and surgical ICUs of Afyonkarahisar Health Sciences University Health Practice and Research Center and T.C. Ministry of Health Kütahya Evliya Çelebi Training and Research Hospital between October 15, 2023, and April 30, 2024. The research data were collected using the Nurse Information Form, the Medical Device-Related Pressure Injury Knowledge Assessment Test (MDRPI-KAT), the Attitude Scale for the Prevention of Pressure Ulcers (APuP), and the Pressure Injury Management Self-Efficacy Scale (PUM-SES) for nurses. SPSS 22.0 software and Hayes' PROCESS macro (Model 4, Version 4.1) were used for data analysis. The average age of the nurses was 29,34±5,40 years, with 64,2% being female, 73,2% holding a bachelor's degree, and 52,6% having 1-5 years of work experience in the ICU. The nurses' MDRPI-KAT score was 9,20±2,32 out of 16 points, with a correct response rate of 57,5%. The nurses' APuP score was 41,42±5,46 out of 52 points, and 76,5% were found to have a satisfactory attitude level (≥75%). The nurses' PUMSES score was 60,59±21,03 out of 100 points. The effect of nurses' knowledge levels on their attitudes was found to be positive and significant (B= 0,963, 95% CI [0,720-1,206]). Additionally, the attitude was found to have a positive and significant effect on self-efficacy (B= 0,837, 95% CI [0,370-1,304]). However, without considering the attitude in the model, the knowledge had no significant effect on self-efficacy (B=0,339, p=0,542, 95% CI [-0,756-1,435]). The mediation effect of attitude in the model explained 70,4% of the total effect. The results of the study revealed that the knowledge levels of ICU nurses regarding MDRPIs were not at the desired level, their self-efficacy levels were slightly above average, and they had a satisfactory attitude. It was also found that attitude had a full mediating effect on the relationship between knowledge level and self-efficacy.