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SECURE Care Bundle to Prevent Medical Adhesive-Related Skin Injury in Paediatric Central Venous Catheter Fixation: A

Özlem Şensoy1, Seda Çağlar2

  • 1School of Nursing, Department of Pediatric Nursing, Istanbul University, Istanbul, Türkiye.

Nursing in Critical Care
|November 5, 2025
PubMed

Insights

This study evaluates the SECURE Care Bundle to prevent medical adhesive-related skin injuries (MARSI) in children with central venous catheters (CVCs). The findings aim to establish standardized practices for better skin protection in pediatric critical care.

Area of Science:

  • Pediatric Critical Care Medicine
  • Nursing Science
  • Wound Prevention

Background:

  • Medical adhesive-related skin injuries (MARSI) are prevalent in pediatric critical care, particularly with central venous catheters (CVCs).
  • MARSI often goes unrecognized despite being a preventable complication associated with medical adhesive use.
  • Adhesive use in pediatric patients requires careful management to prevent skin damage.

Purpose of the Study:

  • To assess the efficacy of the SECURE Care Bundle in preventing MARSI in pediatric patients with CVCs.
  • To evaluate the impact of the SECURE Care Bundle on the time to MARSI onset.
  • To establish a standardized approach for CVC fixation and skin protection.

Main Methods:

  • A quasi-experimental, pre-test/post-test control group design involving 92 pediatric patients.
  • Implementation of the SECURE Care Bundle (skin assessment, secure fixation, adhesive selection, application/removal techniques, adhesive remover use, documentation) in the intervention group.
  • Data collection using descriptive forms, Braden QD Scale, skin observation form, and a checklist.

Main Results:

  • The study will compare MARSI incidence and time to onset between the control (standard care) and intervention (SECURE Care Bundle + standard care) groups.
  • Quantitative data on MARSI occurrence will be analyzed to determine the bundle's effectiveness.
  • The impact on patient skin integrity will be assessed through comparative analysis.

Conclusions:

  • The SECURE Care Bundle is anticipated to be effective in preventing MARSI associated with CVC fixation in pediatric critical care.
  • The study aims to provide evidence for a standardized framework to protect skin integrity and minimize complications.
  • Findings will inform clinical practice, promoting better patient outcomes and reduced MARSI rates.
Abstract

Keywords:
critical caremedical adhesivemedical adhesive‐related skin injurynursingpaediatric

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