Effects of International Standardized Protocols on Knowledge and Practice of Nurses Regarding Bed Sore Ulcer at Private Hospital

Abstract

Background: Pressure ulcers remain a significant yet preventable source of patient morbidity, particularly in immobile and hospitalized individuals. Despite the availability of international protocols for prevention and management, variability in nursing knowledge and practice persists, especially in resource-limited settings. Objective: To evaluate the effectiveness of an educational intervention based on international standardized protocols in improving nurses’ knowledge regarding pressure ulcer prevention and management in a private hospital setting. Methods: A pre-test/post-test quasi-experimental study was conducted among 20 registered nurses at Ali Fatima Hospital, Lahore, Pakistan. Participants were selected through simple random sampling. A structured questionnaire was administered before and after a standardized training session based on NPIAP and EPUAP guidelines. Paired samples t-test was used to compare knowledge scores, with significance set at p < 0.05. Results: The mean knowledge score increased from 3.10 ± 1.57 to 7.90 ± 0.85 following the intervention, yielding a statistically significant mean difference of –4.80 (95% CI: –5.51 to –4.09, p < 0.001). The intervention showed a large effect size (Cohen’s d = 3.18), indicating substantial and consistent improvement across participants. Conclusion: Standardized protocol-based education significantly enhanced nurses’ knowledge of pressure ulcer prevention. Structured training can be an effective strategy for improving clinical competence and care consistency in wound management.