Operating Room Nurses' Knowledge of Medical Device-Related Pressure Injuries and Clinical Decision-Making Skills (OR-MDRPI-KnowD)

The Effect of Operating Room Nurses' Knowledge of Medical Device-Related Pressure Injuries on Clinical Decision-Making Skills: A Scenario-Based Multicenter Cross-Sectional Study

This multicenter, scenario-based cross-sectional study aims to examine the effect of operating room nurses' knowledge of medical device-related pressure injuries on their clinical decision-making skills. The study will be conducted with approximately 165 operating room nurses working in three different hospitals in Gaziantep, Türkiye. Data will be collected using a descriptive information form, a validated medical device-related pressure injury knowledge scale, and a scenario-based clinical decision-making assessment form. The study will evaluate the relationship between nurses' knowledge levels and their clinical decision-making performance, as well as identify factors influencing these outcomes. The findings are expected to contribute to improving patient safety, enhancing nursing education, and supporting evidence-based clinical decision-making in perioperative care.

Study Overview

• Status: Not yet recruiting
• Conditions: Clinical Decision-Making; Medical Device-Related Pressure Injuries
• Intervention / Treatment: Other: None AHT

Detailed Description

Medical device-related pressure injuries (MDRPIs) are a significant and preventable patient safety issue, particularly in perioperative settings where prolonged immobility, decreased tissue perfusion due to anesthesia, and continuous contact with medical devices increase the risk of tissue damage. Studies have reported that the incidence of MDRPIs in surgical patients ranges widely and increases with the duration of surgery. Commonly affected areas include the nasal bridge, ears, lips, and other regions exposed to prolonged pressure from devices such as endotracheal tubes, masks, and fixation materials.

Operating room nurses play a critical role in preventing MDRPIs through appropriate device selection, positioning, skin assessment, and implementation of preventive interventions. International guidelines emphasize the importance of early risk identification and evidence-based clinical decision-making in reducing the occurrence of pressure injuries. However, existing literature indicates variability in nurses' knowledge levels regarding MDRPIs and suggests that this may affect their clinical decision-making processes. Despite the recognized importance of both knowledge and decision-making, studies examining the direct relationship between MDRPI knowledge and clinical decision-making skills among operating room nurses remain limited.

This multicenter, scenario-based cross-sectional study aims to evaluate the effect of operating room nurses' knowledge of MDRPIs on their clinical decision-making skills. The study will be conducted in three hospitals representing different levels of healthcare services in Gaziantep, Türkiye, including a university hospital, a city hospital, and a state hospital. Approximately 165 operating room nurses will be recruited based on predefined inclusion criteria.

Data will be collected using three instruments: a Descriptive Information Form, the Medical Device-Related Pressure Injury Knowledge Scale, and a Scenario-Based Clinical Decision-Making Form developed based on relevant literature and expert opinions. The scenario-based tool consists of multiple clinical situations designed to assess nurses' ability to make appropriate decisions in real-life perioperative contexts.

Data will be analyzed using appropriate statistical methods, including descriptive statistics, group comparisons, correlation analyses, and multiple linear regression to determine the predictive effect of knowledge on clinical decision-making skills. The study is expected to provide evidence on the relationship between knowledge and decision-making in the prevention of MDRPIs and to inform the development of targeted educational interventions aimed at improving perioperative nursing practices and patient safety outcomes.

• Study Type: Observational
• Enrollment (Estimated): 165

Contacts and Locations

• Study Contact: Name: Aynur Koyuncu, Assoc. Prof.; Phone Number: Hasan Kalyoncu Üniversitesi Ha; Email: aynur.koyuncu@hku.edu.tr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

The study population includes operating room nurses employed in three hospitals representing different levels of healthcare services (university, city, and state hospitals) in Gaziantep, Türkiye. Nurses with at least one year of operating room experience who meet the inclusion criteria and provide informed consent will be included in the study.

Description

Inclusion Criteria:

• Operating room nurses who have been working in operating rooms for at least one year Nurses who voluntarily agree to participate in the study Nurses who are able to understand and complete the data collection forms

Exclusion Criteria:

• Nurses who withdraw from the study at any stage after providing consent Incomplete or missing data in the questionnaires

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Operating Room Nurses; Operating room nurses working in different hospitals who participate in the study and complete the knowledge scale and scenario-based clinical decision-making assessment.	Other: None AHT; Operating room nurses recruited from multiple centers who are assessed for their knowledge of medical device-related pressure injuries and clinical decision-making skills using standardized tools.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Clinical Decision-Making Skills Score	Clinical decision-making skills will be assessed using a scenario-based clinical decision-making form consisting of 15 scenarios. Each correct response is scored as 1 and incorrect responses as 0. Total scores range from 0 to 15, with higher scores indicating better clinical decision-making skills.	Baseline (single assessment)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Medical Device-Related Pressure Injury Knowledge Score	Knowledge levels will be measured using a 25-item medical device-related pressure injury knowledge scale. Each correct answer is scored as 1, and incorrect or "I don't know" responses are scored as 0. Total scores range from 0 to 25, with higher scores indicating higher knowledge levels.	Baseline

Collaborators and Investigators

• Sponsor: University of Gaziantep

Publications and helpful links

General Publications

• 1. Tobiano, G., Marshall, A. P., Bucknall, T., & Chaboyer, W. (2025). Medical device-related pressure injuries in surgical settings: A scoping review. Journal of Perioperative Nursing, 38(2), 101-112. https://doi.org/10.1016/j.jopan.2025.01.006 2. Hu, Y., Zhang, X., & Liu, Q. (2025). Risk factors and preventive strategies for medical device-related pressure injuries in perioperative patients: A multicenter observational study. International Wound Journal, 22(1), 58-67. https://doi.org/10.1111/iwj.15042 3. Li, J., Zhou, H., & Wang, L. (2025). Incidence and characteristics of medical device-related pressure injuries among surgical patients: A multicenter study. Wound Management & Prevention, 71(3), 45-54. https://doi.org/10.25270/wmp.2025.03.045 4. Aydınlı, A., & Doğan, M. (2025). Tıbbi cihaz kaynaklı basınç yaraları ve hemşirelik yaklaşımları. Türk Klinik Hemşirelik Dergisi, 17(1), 24-33. https://doi.org/10.5336/nurs.2025-95114 5. Fang, Q., Lin, X., & Zhao, Y. (2025). Skin integrity and device fixation methods: Impact on device-related pressure injuries. Journal of Wound Care, 34(4), 210-219. https://doi.org/10.12968/jowc.2025.34.4.210 6. Crunden, E., Dealey, C., & Banks, M. (2025). EWMA, NPIAP, and EPUAP joint statement on prevention and management of medical device-related pressure injuries. Journal of Wound, Ostomy and Continence Nursing, 52(2), 145-152. https://doi.org/10.1097/WON.0000000000000954 7. Aydınlı, A., & Doğan, M. (2025). Tıbbi cihaz kaynaklı basınç yaraları ve hemşirelik yaklaşımları. Türk Klinik Hemşirelik Dergisi, 17(1), 24-33. https://doi.org/10.5336/nurs.2025-95114 8. Crunden, E., Dealey, C., & Banks, M. (2025). EWMA, NPIAP, and EPUAP joint statement on prevention and management of medical device-related pressure injuries. Journal of Wound, Ostomy and Continence Nursing, 52(2), 145-152. https://doi.org/10.1097/WON.0000000000000954 9. Erzincanlı, S., Yıldız, H., & Demir, N. (2025). Ameliyathane hemşirelerinin tıbbi cihaz ilişkili basınç yaralanmala

Study record dates

Study Major Dates

• Study Start (Estimated): April 25, 2026
• Primary Completion (Estimated): November 25, 2026
• Study Completion (Estimated): December 31, 2026

Study Registration Dates

• First Submitted: April 7, 2026
• First Submitted That Met QC Criteria: April 7, 2026
• First Posted (Actual): April 14, 2026

Study Record Updates

• Last Update Posted (Actual): April 14, 2026
• Last Update Submitted That Met QC Criteria: April 7, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Pressure Injury Prevention; Clinical Decision-Making; Operating Room Nurses; Medical Device-Related Pressure Injurie
• Other Study ID Numbers: 2026/008 (Other Identifier: HKU Ethics Committee Approval No)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No