Nurses' knowledge of medical device-related pressure injuries in an acute setting in Malta : a survey

Abstract

Background: Medical Device-Related Pressure Injuries (MDRPIs) are an emerging concern in acute care settings due to the increased use of life-sustaining devices. Nurses play a critical role in recognising and preventing these injuries; however, knowledge gaps may result in adverse patient outcomes, longer hospital stays, and increased costs. In Malta, limited local research exists on MDRPI knowledge among nurses in acute settings. Objective: To assess whether nurses working in an acute general hospital in Malta possess adequate knowledge regarding the prevention and management of MDRPIs. The study also aimed to identify whether socio-demographic variables influence knowledge levels. Design and Methods: A descriptive, cross-sectional study was conducted using a paper-based questionnaire adapted from a validated tool. Data collection was carried out over five weeks across 41 wards. A total of 723 nurses were eligible, and 360 valid responses were collected, yielding a response rate of 49.8%. Population: The study included nurses working in all adult inpatient wards at a general hospital in Malta, excluding the emergency department, paediatrics, and outpatient clinics. Results: A moderate level of knowledge (63.8%) was found among participants. The lowest scores were observed in the staging subscale, particularly regarding mucosal injuries. Statistically significant associations were found between knowledge levels and variables such as age, belief in the preventability of MDRPIs, information sources, and perceived sufficiency of personal practice. No significant differences were observed for gender, shift type, or previous training. Nurses who accessed structured information or worked with experienced colleagues performed better. Conclusion: The findings suggest that nurses in Malta demonstrate moderate knowledge of MDRPIs, with critical gaps in staging and clinical judgment. To improve care quality and patient safety, recommendations include revising undergraduate curricula, implementing mandatory CPD, and developing institutional policies and multidisciplinary prevention teams.