Nursing students' knowledge, attitudes and learning occasions about pressure injuries at the time of graduation: A multi-method pre-post pandemic study.

Introduction: Pressure injuries (PIs) are a significant issue in healthcare system: nursing students are recommended to be prepared to assess the risk, prevent and manage them. However, despite the coronavirus disease-2019 (COVID-19) pandemic significantly affected nursing students' learning opportunities no data regarding their impact of PIs knowledge, attitudes and learning occasions have been documented to date.

Aims: To describe the post-pandemic knowledge and attitudes regarding PI prevention and management and to compare clinical learning opportunities in the field of PIs before and after the COVID-19 pandemic.

Method: A descriptive multi-method study involving students at the time of their graduation in the before (n = 114) and after the pandemic (n = 113). The Italian versions of the Pressure Ulcer Knowledge Assessment Tool (PUKAT-IT) and Attitude Toward Pressure Ulcer Prevention (APuP-IT) scales were used. Data regarding pre- and post-pandemic learning opportunities were retrospectively collected from the Student Portfolio of Skills.

Results: The average PUKAT-IT score was 57.92 % (cut-off 60 %), which indicates insufficient knowledge; the average APuP-IT score was 78.19 % (cut-off 75 %), which shows positive attitudes towards PI. Comparing the pre- and the post-pandemic groups, learning opportunities in PI risk assessment and prevention significantly decreased (overall 38.90 vs 32.27 and 35.26 vs 25.97, respectively) while those regarding the PI management remained stable.

Conclusion: In the post-pandemic times, nursing students' knowledge about PIs remains insufficient while their attitudes are adequate; the pandemic significantly reduced students' exposure to prevention and assessment learning opportunities during their internship, which suggests a need to update educational strategies to ensure appropriate knowledge and learning experiences in this field.