Development and Feasibility of In Situ Simulation for Pressure Injury Prevention in Intensive Care

OBJECTIVE: To develop, validate and test in situ simulation scenarios aimed at pressure injury (PI) prevention for nursing professionals working in an intensive care unit (ICU). DESIGN: A multi-method study is planned across four phases. METHODS: Conducted at a high-complexity Brazilian university hospital, this four-phase study: (1) development of simulation scenarios and checklists; (2) content validation by 11 experts (CVI/MKC); (3) pilot testing with 12 nursing professionals; and (4) ICU-based educational intervention. Scenarios were grounded in international guidelines and the NLN/Jeffries Simulation Theory. Feasibility was assessed via metrics of acceptability, appropriateness, adoption and fidelity. RESULTS: Two evidence-based simulation scenarios and checklists were developed for registered nurses and nursing technicians, achieving high content validity among 11 experts. The in situ intervention reached 83% of the unit's nursing staff, demonstrating strong operational feasibility and acceptability. Beyond education, the scenarios served as a diagnostic tool, successfully identifying critical practice gaps, notably in Braden Scale utilization, pressure redistribution and the execution of standardized preventive measures. CONCLUSION: The scenarios demonstrated satisfactory content validity and proved feasible for use in ICUs. In situ simulation showed potential to support continuing education actions, promote critical reflection on clinical practice and identify gaps in care processes related to PI prevention. IMPLICATIONS FOR PRACTICE: In situ simulation can contribute to strengthening continuing health education, support the review of care practices and favour the implementation of evidence-based preventive measures for PI prevention in intensive care. PATIENT OR PUBLIC INVOLVEMENT: No patient or public involvement in the development of this study. TRIAL REGISTRATION: https://ensaiosclinicos.gov.br/rg/RBR-4xc2sk8.