Aims and objectives: To determine the level of and factors in nurses’ knowledge, attitudes and behaviours towards pressure injury (PI) prevention.Background: Although there has been a declining trend in global PI prevalence and hospital‐acquired rates in recent years, this has not been the case in China. Evidence in the literature indicates the importance of nurses' knowledge, attitudes and behaviours for promoting PI prevention.Design: Cross‐sectional study.Methods: A total of 1,806 nurses from 10 tertiary general hospitals in Hunan Province, China, participated in this study. Nurses' knowledge and attitudes were assessed using Pieper's Pressure Ulcer Knowledge Test and Attitude towards Pressure Ulcer Prevention Instrument, respectively, and behaviours were measured using a researcher self‐designed questionnaire. Multiple logistic regression analysis determined factors affecting the nurses' PI‐prevention knowledge, attitudes and behaviours. A STROBE checklist was used to report findings.Results: Among all nurses involved in this study, 41.7% had insufficient PI‐prevention knowledge, 46.6% had negative PI‐prevention attitudes, and 21.8% had poor PI‐prevention behaviour. Nurses with a bachelor's degree or above were more likely to have adequate PI‐prevention knowledge. Increased PI‐prevention training frequency increased the nurses’ positive attitude scores for PI prevention; longer years of service and a higher number of PI‐prevention trainings attended predicted better PI‐prevention behaviours.Conclusion: Chinese nurses’ PI‐prevention knowledge and attitudes in this study were unsatisfactory, while their PI‐prevention behaviour was acceptable. Increasing PI‐prevention training frequency can help improve Chinese nurses’ PI‐prevention attitudes and further behaviour. Having a minimum of a bachelor degree may be beneficial to Chinese nurses’ PI‐prevention knowledge, but more evidence is needed.Relevance to clinical practice: Chinese nurses have insufficient knowledge about PI‐repositioning, inadequate practices in PI nutrition assessment, and low confidence in their personal competence regarding PI‐prevention. The key solution for the above issues is to promote ongoing education and training based on strong clinical leadership.

This study explored the direct and indirect effects of risk factors of work-related musculoskeletal disorders (WRMDs) in nurses working in intensive care units (ICUs). A cross-sectional study design was used. ICU nurses from 28 tertiary hospitals in the Hunan and Guangdong provinces participated in a survey conducted via a self-reported online questionnaire. A structural equation model was used to fit the data and to evaluate associations among WRMDs and risk factors. Valid questionnaire samples were submitted by 984 ICU nurses. The prevalence of WRMDs within the previous year among ICU nurses was 96.8%. A valid structural equation model was constructed, and a good fit was shown: Chi-square value/degrees of freedom = 2.248; comparative fit index = .931; normal fit index = .905; goodness-of-fit index = .978; adjusted goodness-of-fit index = .966; and root mean square error of approximation = .036. All regression coefficients for direct effect reached significant levels (critical ratio > 1.96 and p < .05). In the structural equation model, the occurrence of WRMDs was directly affected by the following: physical factors, risk perception, and job stress. Physical factors and a safe environment indirectly affected WRMDs through risk perception and job stress. The strongest correlations with WRMDs were physical factors. The model provided a new perspective for understanding the associations among physical factors, workplace safety environment, risk perception, job stress, and WRMDs. To improve the practice setting of the ICU, efforts should be made to help prevent WRMDs from physical, psychosocial, and environmental factors.

Background: Patient safety is a global challenge influenced by perceived patient safety culture. However, limited knowledge exists regarding the patient safety culture perceived by hospital clinical managers and its associated factors. This study aims to investigate the perceptions of patient safety culture and associated factors among clinical managers of tertiary hospitals in China. Methods: A cross-sectional survey was conducted from June 19 to July 16, 2021, involving 539 clinical managers from four tertiary hospitals in Changsha City of Hunan Province. The Hospital Survey on Patient Safety Culture (HSOPSC) was utilized to assess perceived patient safety culture. Bivariate, multivariable linear regression, and logistic regression analyses were performed. Results: The mean score for the total HSOPSC was 72.5 ± 7.6, with dimensional scores ranging from 62.1 (14.9) to 86.6 (11.7). Three dimensions exhibited positive response rates (PRRs) < 50%, indicating areas that need to be improved: “nonpunitive response to errors” (40.5%), “staffing” (41.9%), and “frequency of events reported” (47.4%). Specialized hospitals (β = 1.744, P = 0.037), female gender (β = 2.496, P = 0.003), higher professional title (β = 1.413, P = 0.049), a higher education level (β = 1.316, P = 0.001), and shorter time delays per shift (β=-1.13, P < 0.001) were correlated with higher perceived patient safety culture. Education level, work department, “teamwork within a unit”, “management support for patient safety”, “communication openness”, and “staffing” dimensions were associated with patient safety grades (all P < 0.05). Years worked in hospitals, occupation, education level, work department, hospital nature, professional title, “communication openness”, and “handoffs & transitions” were associated with the number of adverse events reported (all P < 0.05). Conclusions: Our study revealed a generally low level of patient safety culture perceived by clinical managers and identified priority areas requiring urgent improvement. The associated factors of patient safety culture provide important guidance for the development of targeted interventions in the future. Promoting patient safety by optimizing the patient safety culture perceived by clinical managers should be prioritized.

Aims: To develop the Nurse's Communication Ability with Angry Patients Scale (NCAAPS) and evaluate its psychometric properties.Design: An instrument development and validation study.Methods: The survey was administered to 501 nurses from different emergency departments in China between 2 August 2019 and 3 October 2019. Data from 456 completed questionnaires were analysed to identify the factor structure of the NCAAPS.Results: The content validity index was satisfactory. Four factors were included and 71.25% of the total variance was explained by 19 items in NCAAPS. Confirmatory factor analysis supported the four‐factor structure. Cronbach's α coefficient was 0.96 for the overall scale and 0.81–0.92 for its subscales. Test–retest reliability was 0.740.Conclusion: We consider the NCAAPS to be a useful tool for measuring the ability of nurses to communicate with angry patients.Impact: It is anticipated that this new scale will help educators to identify specific areas of deficiency that could be targeted with training to improve the ability of nursing staff to communicate with angry patients.

Background: Urinary incontinence treatment includes conservative treatment, physical devices, medication, and surgery. Pelvic floor muscle training combined with bladder training is among the most effective, non-invasive, and economical ways to treat urinary incontinence, and compliance with training is essential in urinary incontinence treatment. Several instruments assess pelvic floor muscle training and bladder training. However, no tool has been found that assesses compliance with pelvic floor muscle training when combined with bladder training for urinary incontinence. This study aimed to develop a rehabilitation training compliance scale for patients with urinary incontinence and to evaluate its validity and reliability. Methods: This study was performed in two tertiary hospitals in Hainan, China between December 2020 and July 2021, 123 patients were included. A literature review, group discussions, and two rounds of letter consultations were performed to acquire the item pool and finalise the 12 items for this scale. Exploratory and confirmatory factor analysis, Cronbach’s α, split-half reliability, test–retest reliability, content validity, construct validity, convergent and discriminant validity, and criterion-related validity were used to examine the items in the scale. Results: A 12-item scale comprising three factors accounted for 85.99% of the variance in the data. The Cronbach’s α, split-half reliability, test–retest reliability, and content validity index of the scale were 0.95, 0.89, 0.86, and 0.93, respectively. Comparison with the Chen pelvic floor muscle exercise self-efficacy scale showed high calibration correlation validity (coefficient = 0.89). Conclusions: The training compliance scale developed in this study is a valid and reliable measurement tool to assess pelvic floor muscle training and bladder training compliance in patients with urinary incontinence.