Pressure Ulcer Prevention Care Bundle: A Cross-sectional, Content Validation Study

Wound Manag Prev. 2019 May;65(5):33-39.


A care bundle is an organized set of interventions that encourages compliance with guidelines designed to improve quality of care.

Purpose: This study was conducted to determine the content validity of a previously developed pressure ulcer prevention care bundle.

Methods: A cross-sectional study was performed in a university hospital in Turkey among 95 nurses employed in 8 intensive care units (ICUs) who were invited to use and assess a care bundle based on pressure ulcer guidelines found in the literature and developed by researchers. The care bundle included 48 statements divided into 8 categories. Participants in the care bundle content validation completed 3 paper-and-pencil instruments: a nurse demographic information tool, an item-by-item content validation of the care bundle rated on a 4-point Likert scale, and an evaluation of the care bundle's pressure ulcer prevention capabilities using I agree, I do not agree responses to statements regarding comprehensiveness, ability to prevent pressure ulcers, feasibility, implementation, and complexity. Data were collected to a paper form and analyzed using descriptive statistics, mean scores, and the content validity index (CVI).

Results: Of a total of 95 potential nurse participants, 68 completed the survey instruments (62 [91.2%] women, overall average age 29.9 ± 5.7 years), for a response rate of 71.6%; 57 (83.8%) had bachelors degrees, 36 (52.9%) had between 5 and 10 years of experience, 24 (35.3%) had participated in a pressure ulcer education program, and 41 (69.3%) cared for patients with 1 to 2 pressure ulcers per week. The care bundle's overall mean content validation score was 3.9 ± 0.1; this was deemed valid and appropriate after minor wording modifications on 2 items. Nurses rated the care bundle as comprehensive, feasible, necessary, and helpful for making clinical decisions; 12 participants had concerns regarding its complexity and implementation.

Conclusion: The care bundle may help nurses develop appropriate interventions for patients. Future research should include assessment using larger groups of nurses and construct validation studies.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Female
  • Humans
  • Intensive Care Units / organization & administration
  • Intensive Care Units / statistics & numerical data
  • Male
  • Nurses / psychology*
  • Nurses / statistics & numerical data
  • Patient Care Bundles / methods
  • Patient Care Bundles / standards*
  • Patient Care Bundles / statistics & numerical data
  • Pressure Ulcer / prevention & control*
  • Pressure Ulcer / therapy
  • Surveys and Questionnaires
  • Turkey
  • Validation Studies as Topic