Gap between ERAS knowledge and practice among urology nurses caring for postoperative benign prostatic hyperplasia patients: a cross-sectional study

Enhanced Recovery After Surgery (ERAS) is increasingly applied to BPH surgery, but evidence on how urology nurses translate ERAS knowledge into practice remains limited. We assessed the knowledge–practice gap and factors associated with ERAS nursing practice among urology nurses caring for patients undergoing BPH surgery. This multicenter cross-sectional study included 106 registered urology nurses from seven wards in five hospitals in Yangjiang, China, surveyed from January to May 2026. The variables entered into the multivariable model included hospital level, formal ERAS training, monthly BPH surgical volume, ERAS knowledge score, and knowledge-to-practice translation capacity. The outcome was total self-reported ERAS practice score. Multivariable linear regression was used to examine their independent associations with practice. Overall practice exceeded knowledge (71.8% vs. 68.7%; mean gap, 3.1% points). The largest gap occurred in perioperative thermal management (+ 13.4% points). Hospital level, knowledge, and translation capacity were independently associated with practice: B = 9.02 (95% CI, 4.72–13.32), B = 1.63 (95% CI, 0.79–2.47), and B = 10.38 (95% CI, 5.33–15.42), respectively. Formal training was not independently associated with practice (B = − 1.59; 95% CI, − 6.12 to 2.95). ERAS nursing practice was not determined by knowledge or training alone. Organizational context and the ability to translate knowledge into action may be important targets for strengthening ERAS implementation in BPH surgery.