Nursing Management Experience of Acute Skin Failure in Critically Ill Patients: A Qualitative Study

Abstract

Aim: To explore the management experience of acute skin failure (ASF) in critically ill patients from the perspective of nurses and provide references for improving clinical practice.

Design: A qualitative descriptive study.

Methods: Using purposive sampling, semi-structured interviews were conducted with 13 ICU nurses in a tertiary hospital in East City, China, between January and March 2025. Data were analysed using Colaizzi's phenomenological approach.

Results: Four main themes emerged: (i) Cognitive dilemmas; (ii) Disease control and risk identification; (iii) Management optimisation-from admission preparation to communication and (iv) Multidimensional exploration of nursing interventions. Nurses face challenges such as insufficient awareness, limited tools for early warning, fragmented communication and inadequate multidisciplinary collaboration. These findings suggest the urgent need for structured training, proactive care protocols and enhanced interdisciplinary coordination.

Conclusion: Effective ASF management requires institutional support to build a standardised, technology-enabled care model. Key priorities include tiered training programs for nurses, clearer interdisciplinary roles and the development of validated digital tools for assessment, documentation and real-time risk monitoring. Policymakers and hospital administrators should take concrete actions to strengthen ASF nursing capabilities and integrate systematic response mechanisms into routine care.

Implications for the profession: This study highlights the importance of empowering nurses through structured education, protocol development and digital innovation. Promoting a culture of proactive identification and collaborative care may improve early intervention and reduce adverse skin outcomes. Nursing professionals are encouraged to lead in the integration of ASF management into quality improvement and safety initiatives.

Patient or public contribution: No patient or public contribution.

Keywords: critical illness; nursing; qualitative research; skin failure.