Assessment of Knowledge, Attitude and Practice regarding Patient’s Perioperative Pressure Injury Prevention among the Operating Room Personnel of Medical Teaching Institutions, Peshawar

Main Article Content

Shaheed Ullah
Itizaz Hassan
Israr Ahmad
Muhammad Sulaiman
Zarafshan Sajjad
Noman Hidayat


Background: Pressure injuries (PIs), particularly perioperative pressure injuries (ORPIs), pose significant challenges in patient care, leading to increased morbidity, extended hospital stays, and elevated healthcare costs. Despite established guidelines, the incidence of ORPIs remains a concern, underlining the need for improved prevention strategies within the operating room setting.

Objective: This study aimed to assess the knowledge, attitudes, and practices (KAP) regarding perioperative pressure injury prevention among operating room personnel in medical teaching institutions in Peshawar, Pakistan, to identify knowledge gaps and areas for intervention.

Methods: A cross-sectional descriptive study was conducted over four months, from June to October 2023, involving 264 operating room personnel from three major medical teaching institutions in Peshawar. Participants included nurses, surgeons, and surgical technicians/technologists. Data were collected using structured questionnaires and the KoboCollect mobile application, covering sociodemographic information, and KAP related to perioperative pressure injury prevention. The study employed descriptive statistics, chi-square tests, and Pearson correlation coefficients for data analysis, utilizing IBM-SPSS version 27 and Microsoft Excel 365.

Results: The study revealed a mean knowledge score of 66.02% (SD = 18.99), with 44.3% of participants displaying low knowledge levels (<69%). Attitudes towards pressure injury prevention were predominantly positive, with an average score of 78.17% (SD = 10.38). Practice levels were moderate, with an average score of 79.43% (SD = 10.59), and 54.9% of respondents engaging in high-level practices (≥80%). Significant associations were found between knowledge levels and education (p=<0.001), and between practice levels and both age (p=0.01) and professional role (p=0.006).

Conclusion: The study highlights a critical gap in knowledge regarding perioperative pressure injury prevention among operating room personnel, despite positive attitudes and moderately high practice levels. Addressing this gap through tailored educational programs and policy interventions is crucial for enhancing patient care and preventing ORPIs.

Article Details

How to Cite
Ullah, S., Hassan, I., Ahmad, I., Sulaiman, M., Sajjad, Z., & Hidayat, N. (2024). Assessment of Knowledge, Attitude and Practice regarding Patient’s Perioperative Pressure Injury Prevention among the Operating Room Personnel of Medical Teaching Institutions, Peshawar. Journal of Health and Rehabilitation Research, 4(1), 889–894.
Author Biographies

Shaheed Ullah, Khyber Medical University Peshawar Pakistan.

Surgical Technologist.

Itizaz Hassan, Khyber Medical University Peshawar Pakistan.

Surgical Technologist.

Israr Ahmad, Khyber Medical University Peshawar Pakistan.

Surgical Technologist.

Muhammad Sulaiman, Khyber Medical University Peshawar Pakistan.

Lecturer Surgical.

Zarafshan Sajjad, Khyber Medical University Peshawar Pakistan.

Surgical Technologist.

Noman Hidayat, Khyber Medical University Peshawar Pakistan.

Surgical Technologist


Hu L, Sae-Sia W, Kitrungrote L. Intensive Care Nurses’ Knowledge, Attitude, and Practice of Pressure Injury Prevention in China: A Cross-Sectional Study. Risk Manag Healthc Policy. 2021;14:4257–67.

Al Aboud AM, Manna B. Wound Pressure Injury Management Continuing Education Activity. Available from:

Khong BPC, Goh BC, Phang LY, David T. Operating Room Nurses’ Self-Reported Knowledge and Attitude on Perioperative Pressure Injury. Int Wound J. 2020 Apr;17(2):455–65.

Choi S, Kim YJ, Oh H, Yuh WT, Lee CH, Yang SH, et al. Factors Associated with Perioperative Hospital Acquired Pressure Injury in Patients Undergoing Spine Surgery in the Prone Position: A Prospective Observational Study. J Neurosurg Anesthesiol. 2024 Jan;36(1):45-52.

Couzens L, Peterson B, Innes E, Stevens CJ. The Effect of Wheelchair Cushion Properties on the Microclimate at the Cushion-User Interface: A Systematic Review and Meta-Analysis. Aust Occup Ther J. 2024 Jan 31.

Martins AM, Cohen MA. Knowledge and Clinical Practices Related to Perioperative Pressure Injuries in A Middle Eastern Hospital. 2021.

Islam MS. Nurses’ Knowledge, Attitude, and Practice Regarding Pressure Ulcer Prevention for Hospitalized Patients at Rajshahi Medical College Hospital in Bangladesh.

Wake AD, Tuji TS, Gonfa BK, Waldekidan ET, Beshaw ED, Mohamed MA, et al. Knowledge, Attitude, Practice and Associated Factors Towards Patient Safety Among Nurses Working at Asella Referral and Teaching Hospital, Ethiopia: A Cross-Sectional Study. PLoS One. 2021 Jul;16(7 July).

Bohnen JD, Mavros MN, Ramly EP, Chang Y, Yeh DD, Lee J, et al. Intraoperative Adverse Events in Abdominal Surgery. Ann Surg. 2017 Jun;265(6):1119–25.

Deena Clare Thomas RAN. Dataset on Nurses’ Knowledge, Attitude and Practice in Pressure Injury Prevention at Sabah, Malaysia. 2023. Available from:

Maylor M, Torrance C. Pressure Sore Survey Part 2: Nurses’ Knowledge. J Wound Care. 1999 Feb;8(2):49–52.

Halfens RJG, Eggink M. Knowledge, Beliefs and Use of Nursing Methods in Preventing Pressure Sores in Dutch Hospitals. Int J Nurs Stud. 1995 Feb;32(1):16–26.

Tharu NS, Alam M, Bajracharya S, Chaudhary GP, Pandey J, Kabir MA. Caregivers’ Knowledge, Attitude, and Practice Towards Pressure Injuries in Spinal Cord Injury at Rehabilitation Center in Bangladesh. Adv Orthop. 2022;2022.

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 Feb 2;18(4):1–9.

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.

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 Sep;29(17–18):3311–24.

Beeckman D, Defloor T, Schoonhoven L, Vanderwee K. Knowledge and Attitudes of Nurses on Pressure Ulcer Prevention: A Cross-Sectional Multicenter Study in Belgian Hospitals. Worldviews Evid Based Nurs. 2011 Sep;8(3):166–76.

Simonetti V, Comparcini D, Flacco ME, Di Giovanni P, Cicolini G. Nursing Students’ Knowledge and Attitude on Pressure Ulcer Prevention Evidence-Based Guidelines: A Multicenter Cross-Sectional Study. Nurse Educ Today. 2015 Apr;35(4):573–9.

Khojastehfar S, Najafi Ghezeljeh T, Haghani S. Factors Related to Knowledge, Attitude, and Practice of Nurses in Intensive Care Unit in the Area of Pressure Ulcer Prevention: A Multicenter Study. J Tissue Viability. 2020 May;29(2):76–81.

Amir Zeb Smimkrkhdsb. Knowledge and Attitudes on Pressure Ulcer Prevention Among Nurses Working in Neurological Departments in Tertiary Care Hospitals of Peshawar: A Multicenter Study. ResearchGate. 2017.

Post MWM, Bloemen J, De Witte LP. Burden of Support for Partners of Persons with Spinal Cord Injuries. Spinal Cord. 2005 May;43(5):311–9.