Pressure Ulcer Prevention Practice and its Associated Factors Among Nurses Working in Hospitals: A Systematic Review and Meta-Analysis

Background A pressure ulcer, or bedsore, is an area of skin injury appearing after a prolonged period of insufficient or non-existing blood flow. It causes a significant burden in resource-limited countries like Ethiopia, increasing morbidity, hospitalizations, and healthcare costs. Practice levels and influencing factors nationally remain unclear due to inconsistent regional studies. Objective The primary objective of this study was to determine the pooled national prevalence of good pressure ulcer prevention practice among nurses and the secondary objective was to identify factors associated with these practices. Methods A comprehensive search was conducted in PubMed, Cochrane Library, Hinari, African Journals Online, and Science Direct for observational studies on Ethiopian hospital nurses’ pressure ulcer prevention practices. Study quality was assessed using the Newcastle Ottawa Scale. Meta-analysis was performed using STATA 17. Heterogeneity (I 2 ), publication bias (Egger’s test), and subgroup/sensitivity analyses were performed. Results Eight studies (n=2,032 nurses) were included. The pooled prevalence of good pressure ulcer prevention practice was 48% (95% CI: 38.0%-58.0%). Significant heterogeneity was observed among included studies (I 2 =95.57%). Factors significantly associated with good practice were: good knowledge (AOR=2.79; 95% CI: 1.88, 4.15; p<0.001), leadership satisfaction (AOR=2.168; 95% CI: 1.47, 3.16; p<0.001), presence of guidelines (AOR=1.54; 95% CI: 1.02, 2.33; p=0.014) and job satisfaction (AOR=2.09; 95% CI: 1.06, 4.16; p=0.034). Conclusion Approximately half of nurses demonstrate good pressure ulcer prevention practice, with significant regional variations. Improving nurses’ knowledge, ensuring supportive leadership and ensuring guidelines availability are key modifiable factors to enhance good practice.