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Risk-stratified optimization of skin care protocols for children with cardiac monitors: a data-driven clinical

Kun Zhang1, Ning Chen2, Hui Yuan1

  • 1Department of Pediatric Cardiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.

Frontiers in Pediatrics
|September 15, 2025
PubMed

Insights

A new risk-stratified nursing protocol significantly reduced electrode-related skin injuries (MARSI) in pediatric cardiac monitoring. This evidence-based approach lowers MARSI incidence, improving patient care.

Area of Science:

  • Pediatric Nursing
  • Medical Device Safety
  • Dermatology

Background:

  • Electrode-related skin injuries (MARSI) are a concern in pediatric cardiac monitoring.
  • Standard care protocols may not adequately address individual patient risk factors for MARSI.

Purpose of the Study:

  • To develop and validate a risk-stratified nursing protocol to reduce MARSI in pediatric patients undergoing cardiac monitoring.
  • Identify key risk factors associated with MARSI in this population.

Main Methods:

  • Logistic regression analysis was used to identify risk factors (allergy history, eosinophil indices, wear duration) in a control group (n=229).
  • A risk-stratified protocol was developed based on identified thresholds.
  • The protocol's effectiveness was validated in an intervention group (n=183).

Main Results:

  • MARSI incidence was significantly lower in the intervention group (15.8%) compared to the control group (40.6%) (p<0.001).
  • Risk factors for MARSI included allergy history, prolonged wear time, and elevated eosinophil levels.
  • The intervention group demonstrated reduced rates of skin redness and rashes.

Conclusions:

  • The developed risk-stratified nursing protocol is effective in reducing MARSI incidence in pediatric cardiac monitoring.
  • This protocol supports clinical implementation to enhance patient safety and care quality.
Abstract

Keywords:
cardiac monitoringchildrenmedical adhesive-related skin injurynursing carerisk factors

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