Nursing Students' Knowledge of and Attitudes to Pressure Injury Prevention: A Systematic Review

ABSTRACT

The aim of this study was to examine existing evidence about undergraduate nursing students' knowledge of and attitudes towards pressure injury prevention. A systematic review of primary qualitative, quantitative, and mixed‐methods studies was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. A convergent mixed‐methods synthesis was undertaken. Methodological quality was appraised using the Mixed Methods Appraisal Tool (MMAT). MEDLINE, CINAHL, Scopus, Web of Science, and ERIC were searched on 21 August 2025 for literature published between January 2010 and 21 August 2025. Fifty‐eight studies from 26 countries met the inclusion criteria. Nursing students demonstrated suboptimal knowledge of pressure injury prevention, with mean scores on validated tools (PUKAT/PUKAT 2.0) ranging from 23.5% to 61%, and a pooled mean of 39.2%. Attitudes towards pressure injury prevention were generally positive, with most studies reporting scores > 75% on the APUP instrument and similar tools. Qualitative findings highlighted gaps between theoretical instruction and clinical practice and a need for experiential and simulation‐based learning. Despite positive attitudes, nursing students' knowledge of pressure injury prevention remains inadequate globally. Curriculum redesign incorporating active learning strategies, simulation, and integration of theory with practice is essential.