knowledge, nursing, Pieper-Zulkowski Pressure Ulcer Knowledge Test, pressure ulcer, pressure injury, PZ-PUKT, wound healing



  1. Moharramzadeh, Habibeh MSc
  2. Heidarzadeh, Mehdi PhD, RN
  3. Aghamohammadi-Kalkhoran, Masoomeh PhD, RN


OBJECTIVE: To evaluate the psychometric properties of the Pieper-Zulkowski Pressure Ulcer Knowledge Test (PZ-PUKT) in Iranian nurses.


METHODS: A convenience sample of 323 nurses and 161 nursing students from the Ardabil University of Medical Sciences in Iran agreed to participate in the study. To determine the psychometric properties of the PZ-PUKT content and differential validity, item analysis (difficulty and discriminative indices), internal consistency, and test-retest were performed.


RESULTS: Because the total PZ-PUKT score for critical care nurses (39.84 +/- 7.10) was higher compared with general nurses (37.01 +/- 8.47) and nursing students (24.59 +/- 12.95), the differential validity of the tool was confirmed. The mean difficulty indices of questions with and without considering the "I don't know" option were 0.53 and 0.65, respectively, and 0.27 and 0.13 for discriminative index. Cronbach [alpha] coefficient was .92 for the 72-item test. The correlation coefficient between test and retest for 30 nurses was 0.81.


CONCLUSIONS: This study showed that the Persian version of the PZ-PUKT is valid and reliable for use in Iran. It can be used in education and research to assess nurses' knowledge as well as to evaluate the effectiveness of training programs on prevention and care of pressure injuries.