IOSR Journal of Nursing and Health Science (IOSR-JNHS) e-ISSN: 2320–1959.p- ISSN: 2320–1940 Volume 9, Issue 6 Ser. IV (Nov. – Dec. 2020), PP 38-47 www.iosrjournals.org DOI: 10.9790/1959-0906043847 www.iosrjournals.org 38 | Page Effect of Pressure Ulcer Care Bundle on Nurses' Performance at the Intensive Care Unit Sedika Sadek Ramadan 1 , Sabah Nagah Hasan Mohamed 2 1 (Medical-Surgical Nursing Department, Faculty of Nursing, Helwan University, Egypt( 2 (Medical-Surgical Nursing Department, Faculty of Nursing, Helwan University, Egypt( Abstract Background: Pressure ulcer care bundle is an evidence-based intervention to assist nursing staff in implementing pressure ulcer prevention, it is considered as an essential component to combat the incidence of Pressure ulcers. This study aimed to evaluate the effect of pressure ulcer care bundle on nurses' knowledge and practice at the intensive care unit. Materials and Methods: A convenience sample of 60 nurses working in intensive care units was included in the study. Setting: This study was conducted at medical and surgical intensive care units affiliated to Ain shams University Hospitals. Two tools were used: 1) Self-administered questionnaire (nurse's demographic characteristics and nurse's level of knowledge about pressure ulcer), 2) Observational checklist about pressure ulcer care bundle. Results: the mean age of the nurses was 32.9± 4.71 years. More than half of the nurses had a nursing institute educational level. There were highly statistically significant differences between the nurses as regards knowledge and practice scores pre-post bundle implementation. Conclusion: there was a highly statistically significant improvement regarding nurses’ knowledge and practice from pre to post-implementation of the bundle, and there were highly statistically significant correlations between scores of nurses’ knowledge and scores of nurses’ practice post bundle implementation. This study recommended that future research needs to be conducted to compare the retention of nurses’ performance over time based on differences in the used methods of evaluation. Keywords: Pressure ulcer care bundle, knowledge, practice. --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 28-11-2020 Date of acceptance: 13-12-2020 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Pressure ulcer (PU) is major health problem causing severe consequences for patients, for health professionals, as well for health care institutions because of the high costs of its management. (López-Franco, Anguita, Comino-Sanz, & Pancorbo, 2020). Intensive care units are reported to have the highest pressure ulcer prevalence rates among hospital settings since critically ill patients are expected to have much morbidity that increases the risk of pressure ulcer development. As ulcers are considered to be preventable problems, nurses who're in direct contact with these patients have a main role in preventing them from developing (Habiballah, 2018). In the intensive care unit, patients have many issues that increase the risk of developing pressure ulcers. Generally, the patient has respiratory equipment, multiple intravenous catheters, urinary catheters, compression equipment, and the infusion of vasoactive agents for hypotension that may lead to the inability to turn patients and increase the risk of pressure ulcer development. Management and prevention of pressure ulcers, as an important quality of care indicator for all health care organizations, require a multidisciplinary team having a holistic care approach (Mallah, Nassar & Kurdahi, 2015). Nurses in this team have vital roles in the protection of skin integrity and the prevention of complications. Evidence-based nursing interventions applied in the initial period have great significance in the prevention of pressure ulcers (Köse et al., 2016). Management of pressure ulcer highlighting that prevention is better than cure. Thus, the pressure ulcer care bundle is reflected as an important component of pressure ulcer prevention that depends upon adequate knowledge and practice as well as effective identification and prediction of the patient’s risk factors (Roberts et al., 2016). So nurses play a critical role in the prevention of pressure ulcers, as she is the one who early detects the signs of pressure ulcers during patients’ stay in hospitals. The methods of pressure ulcer prevention need skilled nursing assessment of the integumentary system and knowledge of risk factors, in addition to a continuing evaluation plan to detect the incidence and efficacy of nursing care (Mohamed& Weheida, 2015). Pressure ulcer care bundle is an evidence-based intervention to support nurses in applying pressure ulcer preventions (Hashad, & Hassan, 2018). The evidence-based care bundle contains five basic elements: