A cross-sectional study on knowledge, attitudes, and practices of occupational protection among central sterile supply department nurses: current status, associated factors, and an exploratory path analysis

This study aimed to investigate knowledge, attitudes, and practices (KAP) regarding occupational protection among Central Sterile Supply Department nurses. A cross-sectional online survey was conducted among a convenience sample of Central Sterile Supply Department nurses recruited through a province-level CSSD professional network in Zhejiang Province, China, between 4 January and 1 March 2026. A self-designed questionnaire with acceptable reliability (Cronbach’s α = 0.725) was used to assess demographic characteristics and the three KAP dimensions. A total of 306 participants were included; most were female (95.8%), aged > 45 years (41.5%), and had a bachelor’s degree or above (85.3%). Mean knowledge, attitude, and practice scores were 14.77 ± 1.73 (possible range: 0–18), 37.06 ± 2.87 (possible range: 8–40), and 45.90 ± 3.52 (possible range: 10–50), respectively. Path analysis revealed that attitudes showed the strongest direct association with practices (β = 0.542, P = 0.014). In multivariable analysis, higher attitude scores (β = 0.667, 95% CI: 0.549–0.784, P < 0.001) and ≥ 3 training sessions/year (β = 0.930, 95% CI: 0.062–1.798, P = 0.036) were associated with better practices, whereas 11–20 years (β=−1.249, P = 0.049) and > 30 years (β=−1.773, P = 0.009) of nursing experience were associated with lower practice scores, suggesting experience-related variations rather than a direct negative impact. Attitudes correlated strongly with practices ( r = 0.584, P < 0.001), whereas knowledge showed no significant correlation with attitudes ( r = 0.088, P = 0.125). In this convenience sample, CSSD nurses in Zhejiang Province showed favourable self-reported occupational protection attitudes and practices, but exhibited substantial and critical item-level deficits in knowledge regarding bloodborne exposure management and post-exposure prophylaxis timing. Implementing a mandatory, high-frequency (≥ 3 sessions per year), scenario-based occupational protection training programme linked to annual performance evaluation, alongside targeted modules for senior nurses, is recommended to improve protective practices. Not applicable.