Knowledge, Attitudes and Practices of Nurses Regarding Diabetic Foot Ulcer Care at Sunyani Teaching Hospital, Ghana: A Cross-Sectional Study

Background Diabetic foot ulcers (DFUs) are a leading cause of morbidity, lower-limb amputation, and mortality among people with diabetes, particularly in low- and middle-income settings. Nurses constitute the largest segment of the healthcare workforce and are central to diabetic foot ulcer (DFU) prevention and management; however, evidence on nurses’ knowledge, attitudes, and practices (KAP) in Ghana remains limited. This study assessed nurses’ KAP regarding DFU care at a tertiary referral hospital in Ghana. Methods A hospital-based cross-sectional study was conducted among nurses providing direct patient care at Sunyani Teaching Hospital between September and November 2025. A total of 128 nurses were invited to complete a structured, self-administered online questionnaire. The instrument assessed socio-demographic characteristics and DFU-related knowledge (15 items categorized using Bloom’s cut-off points), attitudes (Likert-scale items), and practices (Yes/No items). Descriptive statistics summarized the data, and chi-square tests were used to examine associations between DFU knowledge levels and selected socio-demographic and professional variables, with statistical significance set at p < 0.05. Results A response rate of 100(78.1%) was recorded, 77% being females, aged 31–45 years (72%), and majority (90%) had never received any formal training in DFU care. Overall, 61% demonstrated good knowledge of DFU care, 30% had moderate knowledge, and 9% had poor knowledge. Knowledge was highest for selected dressing-related items, including interpretation of slough and use of iodine dressings, but lowest for mechanical off-loading and ischemia-associated amputation risk. Attitudes toward DFU care were generally positive, although time and workload constraints were frequently reported. Common practices included patient education on footwear and hygiene (81%), foot inspection (74%), and referral of suspected DFU cases (75%); however, use of standardized neuropathy screening tools was very low (10%), and documentation of foot-care education was inconsistent (52%). Knowledge level was associated with age (p = 0.040), academic qualification (p = 0.002), years of practice (p = 0.016), and prior DFU training (p < 0.001). Conclusions Despite generally positive attitudes and routine involvement in DFU care, important gaps persist in preventive knowledge and evidence-based screening practices. Structured formal DFU training and institutional support are needed to improve care quality and outcomes. Future research should examine nurses' challenges to providing evidence-based care for diabetic foot ulcers and assess how nurse-led training affects patient outcomes and practice in Ghana.