Significant attention has been given to reducing pressure ulcers, with many resources being produced by the National Wound Care Strategy and campaigns such as Stop the Pressure. 

As tissue viability nurses, the prevention of pressure ulcers is always at the forefront of our minds, and will continue to be in the future, due to the pain and suffering they can cause to patients. While this is undoubtedly an important patient harm, another significant problem, moisture-associated skin damage (MASD) is still not getting the attention it deserves, despite it also having a negative impact on patient wellbeing and quality of life. It was included as a national recommendation, given the risks of pressure ulcers linked to moisture, that organisations should record incidents of MASD in the same way as pressure ulcers (NHS Improvement, 2018) but it feels there is still some way to go to raising awareness of the importance of its prevention and further improving practice. 

MASD is an umbrella term, which covers a range of skin damage caused by repeated or prolonged moisture on the skin, from perspiration, urine, faeces or wound exudate. The harmful effects of excessive moisture can occur at any age, in any setting.

At the beginning of 2019, an innovative education and awareness campaign to reduce the incidence of MASD called MINIMISE Moisture™ was developed and implemented in Liverpool Heart and Chest Hospital NHS Foundation Trust (LHCH). The Tissue Viability Nurses at LHCH talked to patients about their experiences, providing powerful messages to share with staff. Patients described MASD as ‘painful, burning, unbearable and embarrassing.’ Staff were asked about their knowledge of MASD and it was concluded that it was varied and often limited. ‘MINIMISE’ was an acronym compiled after a review of the current literature and best practice of MASD (Tyrer, 2021). The acronym served as a useful reminder of the key considerations in the prevention of MASD.

Education and awareness are key in MASD reduction and the MINIMISE Moisture campaign achieved a threefold reduction in cases of MASD. A staff survey highlighted that 90% of staff felt the campaign had raised their awareness of MASD, 96% felt better able to identify patients at risk and 91% felt better equipped to provide high-quality care as a result.

After the success of the local MINIMISE Moisture campaign at LHCH, tissue viability nurses worked collaboratively with industry partner Medline and launched the first ever national MASD Awareness Day, with 100 NHS organisations registering their interest to participate. The vision was that local campaigns could be aligned on this day, to raise the profile of MASD as a patient harm and to raise awareness of its prevention and management. 

Awareness campaigns have been shown to help motivate, educate and inform staff and patients about health matters. A national MASD awareness day has many potential benefits:

• Raising the profile of MASD as a patient safety issue to relevant staff and key stakeholders.
• Raising awareness of the key considerations around prevention and management with increase staff and patient knowledge and improved clinical practice as a result.
• Reducing incidences of MASD and avoidance of costs to patients in terms of pain and suffering associated with MASD and financial costs associated with the treatment of MASD.
• Reducing new pressure ulcer development, and associated costs of treatment and potential litigation which may develop because of primary skin damage caused by MASD. 

Since the launch of the first MASD Awareness Day in 2022, over 200 healthcare organisations have run their own days. 97% of respondents said new knowledge learnt from MASD Awareness Day helped improve their clinical practice. 

Awareness days work by gaining increased exposure each year, as more and more people hear about it or recognise it. The aim is to make this year’s MASD Awareness Day even bigger and better, inviting all care settings to join in. The day can provide a powerful platform for accelerating learning and development around MASD. We chose the third Thursday in March for these days (in line with the third Thursday in November for Stop the Pressure). So, a date for the diary is 20 March 2025, but organisations may want to run local events near this day or even over the course of the week! 

Our digital campaign kits give organisations a great starting point. Organisations can tailor the MASD Awareness Day campaign materials, adding their own logo.

Check out what other organisations have done on previous MASD Awareness days 

#MASDAwareness, #ThinkMASD, #MINIMISEMoisture