For our Wound Research Voices feature in January, we are pleased to share a short summary of a PhD thesis by Ayşe Sılanur Demir-Üçtepe, Koç University Institute of Health Sciences, Department of Fundamentals of Nursing, Istanbul, Turkey. The title of the thesis is Development of a Nursing Care Bundle for the Prevention of Pressure Injuries and its Impact on the Rate and Cost of Pressure Injuries.

Summary, methodology & clinical relevance 

Hospital-acquired pressure injuries (HAPIs) remain a common yet largely preventable problem in intensive care units, contributing to increased morbidity, prolonged hospitalization, and higher healthcare costs. This doctoral study aimed to develop and evaluate a structured Pressure Injury Prevention Care Bundle (PIP-CB) to enhance the consistency and effectiveness of preventive nursing care in critically ill adults. 

A randomized controlled trial was conducted in an adult ICU, comparing the PIP-CB with standard care. The bundle included systematic risk assessment, structured skin inspection, repositioning, microclimate management, and prophylactic skin protection. Pressure injuries occurred in 17.8% of patients in the intervention group versus 46.7% in the control group, with a longer median time to injury development in the intervention group (7 vs. 3 days). 

In addition to improved clinical outcomes, the PIP-CB was associated with reduced pressure injury–related costs, demonstrating favorable cost-effectiveness. These findings support the use of standardized, evidence-based care bundles as an effective and sustainable strategy to improve patient safety and resource use in intensive care settings. 

Publications 

1. Demir-Üçtepe, A. S., Battal, A. E., Güleç, C., Ergün, E., Bakcaci, A., Karadağ, A., & Demir, Ç. G. D. (2025). Artificial Intelligence-Enabled Staging Classification of Pressure Injuries. Advances in Skin & Wound Care, 38(9), 480-486. DOI: 10.1097/ASW.0000000000000352 https://journals.lww.com/aswcjournal/abstract/2025/10000/artificial_intelligence_enabled_staging.6.aspx?context=latestarticles 
2. Demir-Üçtepe, A. S., & Karadag, A. (2025). Impact of Care Bundles Prevention of Hospital‐Acquired Pressure Injuries: A Systematic Review and Meta‐Analysis. Nursing Open, 12(3), e70173. https://doi.org/10.1002/nop2.70173   https://onlinelibrary.wiley.com/doi/full/10.1002/nop2.70173  
3. Çakar, V., Karadağ, A., & Demir-Üçtepe, A. S., (2025). Skin Problems in the Facial Area due to the Use of Personal Protective Equipment in Healthcare Workers: A Systematic Review. Journal of Clinical Nursing. . https://doi.org/10.1111/jocn.17695 https://onlinelibrary.wiley.com/doi/full/10.1111/jocn.17695  
4. Gül, Ş., Demir-Üçtepe, A. S., Karadağ, A., & Karaçay, P. (2025). Determining the quality of life and associated factors in patients with pressure injury. Journal of Tissue Viability. 34(1); 100835. https://doi.org/10.1016/j.jtv.2024.11.007  https://www.sciencedirect.com/science/article/pii/S0965206X24001633  
5. Sengul, T., Karadag, A., Kilic, H., Ucanbelen, A., & Demir-Üçtepe, A. S., (2025). Analysis of YouTube videos focusing on ileostomy, colostomy, urostomy care, and pouching system changes. Journal of Wound, Ostomy and Continence Nursing, 00(0), 1–6. https://journals.lww.com/jwocnonline/abstract/9900/analysis_of_youtube_videos_focusing_on_ileostomy,.25.aspx  
6. Karadaǧ, A., Çakar, V., & Demir-Üçtepe, A. S., (2024). An inter-assessor reliability study on the categorization and staging of pressure injuries. Journal of Tissue Viability, 33(4), 786-791. https://www.sciencedirect.com/science/article/abs/pii/S0965206X24001451  
7. Savaş, E. H., Demir-Üçtepe, A. S., Semerci, R., & Karadağ, A. (2023). Effect of virtual reality on pain during burn dressing in children: A systematic review and meta-analysis of randomized controlled trials. Journal of Pediatric Nursing, 73, e364-e371. https://doi.org/10.1016/j.pedn.2023.10.002 https://www.sciencedirect.com/science/article/abs/pii/S0882596323002798  
8. Şimşek, E., Demir-Üçtepe, A. S., Semerci, R., & Karadağ, A. (2023). The incidence and prevalence of medical device-related pressure injuries in pediatric patients: systematic review and meta-analysis. Journal of Pediatric Nursing, 72, e130-e138 https://doi.org/10.1016/j.pedn.2023.06.019 https://www.sciencedirect.com/science/article/abs/pii/S0882596323001513  
9. Çakar, V., Karadağ, A., Bugan, B., Kılıç, H., & Demir-Üçtepe, A. S., (2023). Personal Protective Equipment-Related Problems Experienced by Healthcare Workers, Solutions, and Recommendations: A Qualitative Study. Advances in Skin & Wound Care, 36(11), 1-9. DOI: 10.1097/ASW.0000000000000059