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Effect of Implementing a Nursing-Led SKINCARE Bundle for Preventing Medical Device-Related Pressure Injury in
Amina Hemida Salem Ghattas1, Nagwa Ahmed Reda1, Lamia Reda Ahmed Elgazzar1
1Critical Care & Emergency Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt.
Background:
Medical device-related pressure injuries (MDRPIs) are generally preventable yet increasingly recognised complications in critical care units, contributing to patient harm, prolonged hospitalisation and higher costs. A nursing-led skincare bundle may provide a structured, evidence-based approach to standardising practice for the prevention of MDRPIs.
Aim:
This study aimed to evaluate the effect of implementing the SKINCARE bundle on the prevention of MDRPIs in critically ill patients.
Study Design:
A quasi-experimental study in critical care units evaluating the effect of a SKINCARE bundle, which included skin assessment, repositioning, moisture management, securing medical devices and protecting the skin with special dressings, on preventing MDRPIs.
Results:
A total of 110 critically ill patients were included and equally allocated to the control (n=55) and intervention (n=55) groups. A higher proportion of patients in the intervention group were free of MDRPIs compared with the control group (n=22 [40%] vs. n=6 [10.9%], p < 0.001). In contrast, stage II and III injuries were observed only in the control group (23.6% and 10.9%, respectively), while no such injuries occurred in the intervention group. Device-specific analysis showed significantly fewer MDRPIs in the intervention group across all devices (all p < 0.001).
Conclusion:
The nursing-led SKINCARE bundle effectively reduced the incidence and severity of medical device-related pressure injuries in critically ill patients. Lower Braden scores, poorer nutritional status and impaired perfusion were associated with higher MDRPI risk, while improved nutrition and oxygenation were protective. These findings support the effectiveness of structured, evidence-based nursing interventions for enhancing skin integrity and patient safety in critical care.
Relevance To Clinical Practice:
The nursing-led SKINCARE bundle provides a practical, evidence-based framework and standardised prevention strategy that can be integrated into routine care practice to enhance patient safety, reduce preventable harm and improve outcomes. Its adoption also supports the clinical policy initiatives by reinforcing MDRPI prevention as a core nursing-sensitive quality indicator.
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