Reducing the Incidence of Medical Adhesive-Related Skin Injuries in the Neonatal Intensive Care Unit
Abstract
Purpose: Our Neonatal Intensive Care Unit (NICU) primarily cares for preterm infants born under 32 weeks with severe conditions, requiring medical adhesives to secure life-sustaining devices and tubing. Due to underdeveloped skin and poor nutrient absorption, these infants are at high risk of skin injuries from improper adhesive use, leading to pain, infection, and increased care difficulty.
In October-November 2023, the MARSI rate in our unit was 7.27%, most often occurring during endotracheal tube tape removal. To address this, we collaborated with the NICU director, head nurse, and senior staff to develop MARSI-focused training, establish a "Medical Adhesive Skin Care Audit Checklist," and change the method of securing endotracheal tubes. Our goal is to reduce MARSI rates and improve neonatal skin care skills and quality.
Methods:
- Collaborate with the head nurse, NICU director, and senior nurses to establish a shared understanding of the severity of Medical Adhesive-Related Skin Injury (MARSI). Plan the tasks and content for a skin care in-service training program, covering topics such as an introduction to MARSI, skin and wound assessment, prevention of adhesive-related skin injuries, types of medical adhesive products, dressing selection and application, and techniques and precautions for applying and removing adhesives.
- Organize simulation training for skin care, using commonly utilized medical adhesive products in the unit, including artificial skin, Tegaderm, Elar tape, infant-specific tape, ventilated tape, and ECG electrodes. These products are applied to the hands and arms of nursing staff for hands-on practice, allowing them to experience any discomfort caused by improper application or removal techniques.
- After reviewing the literature, compile key points on the use and care of neonatal medical adhesives, and establish a "Medical Adhesive Skin Care Audit Checklist."
- Replace the traditional endotracheal tube securing method using Elar tape with a tubing fixation device. Adjust the frequency of securing changes from daily to weekly to reduce the frequency of adhesive removal.
Results: Using the "NICU Medical Adhesive-Related Skin Injury Log," we tracked a decrease in MARSI incidence from 7.27% to 2.5% between October 2023 and October 2024. Nurses provided positive feedback after in-service training, noting that hands-on simulations enhanced their skills and retention for accurate practice.
Notes
References:
Mishra, U., Jani, P., Maheshwari, R., Shah, D., D'Cruz, D., Priyadarshi, A., ... & Wright, A. (2021). Skincare practices in extremely premature infants: A survey of tertiary neonatal intensive care units from Australia and New Zealand. Journal of Paediatrics and Child Health, 57(10), 1627-1633. https://doi.org/gkqz8h
Pires-Júnior, J. F., Chianca, T. C. M., Borges, E. L., Azevedo, C., & Simino, G. P. R. (2021). Medical adhesive-related skin injury in cancer patients: A prospective cohort study. Revista Latino- Americana de Enfermagem, 29. https://doi.org/gpvz7f
Hadfield, G., De Freitas, A., & Bradbury, S. (2019). Clinical evaluation of a silicone adhesive remover for prevention of MARSI at dressing change. Journal of Community Nursing, 33(3), 36-41.
Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Simulation, Acute Care, Neonatal Intensive Care Unit, NICU, Skin Injuries, Skin Injury Prevention
Recommended Citation
Huang, Ya-Lin; Lin, Chia Yi; Kao, Hui Min; Lin, Hsiang-Yu; and Tsai, Chieh-Min, "Reducing the Incidence of Medical Adhesive-Related Skin Injuries in the Neonatal Intensive Care Unit" (2025). International Nursing Research Congress (INRC). 115.
https://www.sigmarepository.org/inrc/2025/posters_2025/115
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Reducing the Incidence of Medical Adhesive-Related Skin Injuries in the Neonatal Intensive Care Unit
Seattle, Washington, USA
Purpose: Our Neonatal Intensive Care Unit (NICU) primarily cares for preterm infants born under 32 weeks with severe conditions, requiring medical adhesives to secure life-sustaining devices and tubing. Due to underdeveloped skin and poor nutrient absorption, these infants are at high risk of skin injuries from improper adhesive use, leading to pain, infection, and increased care difficulty.
In October-November 2023, the MARSI rate in our unit was 7.27%, most often occurring during endotracheal tube tape removal. To address this, we collaborated with the NICU director, head nurse, and senior staff to develop MARSI-focused training, establish a "Medical Adhesive Skin Care Audit Checklist," and change the method of securing endotracheal tubes. Our goal is to reduce MARSI rates and improve neonatal skin care skills and quality.
Methods:
- Collaborate with the head nurse, NICU director, and senior nurses to establish a shared understanding of the severity of Medical Adhesive-Related Skin Injury (MARSI). Plan the tasks and content for a skin care in-service training program, covering topics such as an introduction to MARSI, skin and wound assessment, prevention of adhesive-related skin injuries, types of medical adhesive products, dressing selection and application, and techniques and precautions for applying and removing adhesives.
- Organize simulation training for skin care, using commonly utilized medical adhesive products in the unit, including artificial skin, Tegaderm, Elar tape, infant-specific tape, ventilated tape, and ECG electrodes. These products are applied to the hands and arms of nursing staff for hands-on practice, allowing them to experience any discomfort caused by improper application or removal techniques.
- After reviewing the literature, compile key points on the use and care of neonatal medical adhesives, and establish a "Medical Adhesive Skin Care Audit Checklist."
- Replace the traditional endotracheal tube securing method using Elar tape with a tubing fixation device. Adjust the frequency of securing changes from daily to weekly to reduce the frequency of adhesive removal.
Results: Using the "NICU Medical Adhesive-Related Skin Injury Log," we tracked a decrease in MARSI incidence from 7.27% to 2.5% between October 2023 and October 2024. Nurses provided positive feedback after in-service training, noting that hands-on simulations enhanced their skills and retention for accurate practice.
Description
Through specific measures such as developing skin care education programs, conducting simulation training, and establishing a "Medical Adhesive Skin Care Audit Checklist," the incidence of medical adhesive-related skin injuries decreased from 7.27% to 2.5%. These initiatives also enhanced the knowledge, professional skills, and skin care abilities of the nursing staff in the unit.