The difficulties on management of pressure injuries encountered by pediatric nurses working in intensive care units in Türkiye: a descriptive qualitative study

Abstract

Purpose: This study aimed to explore the experiences and perceptions of pediatric intensive care nurses regarding pressure injury prevention and management, focusing on identifying challenges, barriers, and system-level vulnerabilities in clinical practice. Design and methods: A descriptive qualitative design based on naturalistic inquiry was adopted. Data were collected from 28 pediatric intensive care nurses in Turkey between January and June 2025 using structured tools with demographic forms and open-ended questions. Participants were recruited through purposive sampling via social media and professional WhatsApp groups. Data saturation was reached, and analysis followed Downe-Wamboldt's content analysis framework. Results: Two main themes and six sub-themes emerged. The themes were: (1) Clinical Outcomes of Inadequate Training and Protocol Deficiencies, and (2) Structural Vulnerabilities and Compensatory Improvisation in Pediatric Care Delivery. Sub-themes highlighted issues such as unsupported decision-making, educational inadequacies, protocol misalignment, resource limitations, improvised care strategies, and the emotional burden. Conclusions: The study highlights the urgent need for pediatric-specific protocols, consistent access to equipment, and hands-on training to bridge theory and practice. Institutional efforts must address structural and educational gaps to support nurses and improve care quality. Practice implications: The findings are crucial for developing targeted educational programs, revised clinical protocols, and policy reforms aimed at reducing the incidence of pressure injuries and improving overall nursing care quality in pediatric settings. (c) 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.