Background: In critical care units (ICUs), the incidence of pressure ulcers (PU) is significant, with a low compliance rate for PU prevention standard care. Despite the fact that studies have publicized that PU are mostly preventable, there is a lack of a Pu nursing cluster bundle based on the best evidence in e ICUs. This study was aimed to investigate effect of effect of implementing nursing cluster bundle on prevention of pressure ulcer among critically ill patients in trauma intensive care unit. Quasi-experimental research design was carried out to meet the aim of this study. A purposive sample included 85 adult patients are taken from trauma intensive care unit in Aswan University Hospital. Three tools were utilized to collect data in this study. Tool 1,Comprehensive Skin Assessment Tool; this tool consisted of two main parts:Part one-Socio- demographic and clinical data of the patient Part two- Assessment data of pressure ulcer it include, Evaluate skin temperature, color, moisture, turgor, and integrity and tissue perfusion, Pressure ulcer Stages,and Location of pressure ulcer. Tool 2, Braden Risk Assessment Scale to assess the patient's level of risk for developing pressure ulcers. Tool 3, the nursing cluster pressure ulcer prevention bundle It is consisted of six main items considering with supporting body surface, inspecting skin, keeping moving and repositioning, incontinence care, nutrition and hydration and preventive skin care measures. Results: There were highly statistically significant differences between the two methods of suctioning as regards the mean of respiratory rate, Oxygen saturation, among children before, during and after the closed and open suctioning methods, (P<0.001**) while no statistically significant difference were found as regards the mean of heart rate, systolic and diastolic blood pressures. Conclusion: The use of the closed suction system leads to less disturbances in the cardiorespiratory parameters compared to open suction system among children under mechanical ventilation. Recommendation: Nurses should be encourage in all pediatric intensive care units and trained to implement closed suction system in their sitting.