Associations of a nursing care bundle with clinical outcomes in patients with severe burns and inhalation injury: a retrospective cohort study

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Aim To evaluate the associations of a comprehensive nursing care bundle on clinical outcomes in patients with severe burns and inhalation injury. Methods A retrospective cohort study was conducted on 130 patients admitted to a burn ICU from July 2022 to December 2024. Patients were divided into a Comprehensive Care Group (Group A, n = 65) receiving a protocol of ultrasound-guided venous catheterization through burn wounds, tracheostomy via burn wounds, systematic air-fluidized bed management, and intensified diabetic foot prevention, and a Conventional Care Group (Group B, n = 65). Results Group A was associated with lower rates of catheter-related bloodstream infection (1.6% vs. 11.3%, p = 0.033), delayed onset of ventilator-associated pneumonia, reduced back wound deterioration (12.3% vs. 40.0%, p < 0.001), and zero incidence of diabetic foot in the diabetic subgroup (0% vs. 47.1%, p < 0.001). Overall, Group A had shorter hospital stays, lower MODS incidence (15.4% vs. 36.9%, p = 0.005), and reduced mortality (7.7% vs. 21.5%, p < 0.001). Conclusion In patients with severe burns complicated by inhalation injury, implementation of the diversified bundled nursing strategy was associated with improved clinical outcomes and appeared to be safe in this retrospective cohort. However, because of the retrospective design and potential residual confounding, these findings should be interpreted with caution and should not be considered definitive evidence of causality.