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Article

Assessment of Nurses’ Knowledge Regarding Pressure Injury: A National Multicenter Cross-Sectional Study

by
Ana Žepina Puzić
1,2,* and
Bojana Filej
1
1
Faculty of Health Sciences, University of Novo Mesto, 8000 Novo Mesto, Slovenia
2
Department of Health Studies, Šibenik University of Applied Sciences, 22000 Šibenik, Croatia
*
Author to whom correspondence should be addressed.
Healthcare 2026, 14(13), 1948; https://doi.org/10.3390/healthcare14131948
Submission received: 27 April 2026 / Revised: 7 June 2026 / Accepted: 29 June 2026 / Published: 1 July 2026

Abstract

Background/Objectives: Improving the prevention and management of pressure injuries requires adequate nursing knowledge. In this context, understanding the current knowledge levels of nurses is important for informing educational and organizational strategies. This study aimed to assess the pressure injury knowledge of nurses at the national level and examine differences according to their educational, professional, and informational characteristics. Methods: A national cross-sectional quantitative study was conducted in public secondary-level hospitals in the Republic of Croatia. A total of 1139 participants from 19 hospitals across all four geographical regions of Croatia participated. The PZ-PUNKT instrument was used, and an analysis was conducted using descriptive and bivariate inferential statistics. Results: Participants with bachelor’s and master’s degrees achieved higher PZ-PUKT scores than those with secondary education (p = 0.026 to < 0.001), although the effect sizes were very small (ε2 = 0.008–0.017). Significant differences were observed across clinical departments (p < 0.001; ε2 = 0.03–0.04), whereas no statistically significant differences were found according to the frequency of working with patients with pressure injuries (p > 0.05). Participants who reported recently attending educational activities, consulting the professional literature, or searching for information achieved higher knowledge scores across all domains (p < 0.001); however, the effect sizes remained small (ε2 = 0.034–0.060; rpb = 0.133–0.214). Conclusions: Although the observed effect sizes were generally small, higher knowledge scores were observed among nurses who reported recent engagement with educational activities, the professional literature, and information-seeking behaviors. No significant differences were identified according to the frequency of working with patients with pressure injuries. These findings provide a national overview of pressure injury knowledge among Croatian nurses and may inform future educational initiatives and research.
Keywords: nursing education; nursing knowledge; Pieper–Zulkowski Pressure Ulcer Knowledge Test; pressure injury; education; pressure ulcer prevention nursing education; nursing knowledge; Pieper–Zulkowski Pressure Ulcer Knowledge Test; pressure injury; education; pressure ulcer prevention

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MDPI and ACS Style

Žepina Puzić, A.; Filej, B. Assessment of Nurses’ Knowledge Regarding Pressure Injury: A National Multicenter Cross-Sectional Study. Healthcare 2026, 14, 1948. https://doi.org/10.3390/healthcare14131948

AMA Style

Žepina Puzić A, Filej B. Assessment of Nurses’ Knowledge Regarding Pressure Injury: A National Multicenter Cross-Sectional Study. Healthcare. 2026; 14(13):1948. https://doi.org/10.3390/healthcare14131948

Chicago/Turabian Style

Žepina Puzić, Ana, and Bojana Filej. 2026. "Assessment of Nurses’ Knowledge Regarding Pressure Injury: A National Multicenter Cross-Sectional Study" Healthcare 14, no. 13: 1948. https://doi.org/10.3390/healthcare14131948

APA Style

Žepina Puzić, A., & Filej, B. (2026). Assessment of Nurses’ Knowledge Regarding Pressure Injury: A National Multicenter Cross-Sectional Study. Healthcare, 14(13), 1948. https://doi.org/10.3390/healthcare14131948

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