Medical adhesive-related skin injuries (MARSI) significantly impact patient comfort and healthcare outcomes. This Quality Improvement Project (QIP) at Rajagiri Hospital Aluva (Kerela) aimed to reduce MARSI incidence through enhanced adhesive practices and staff training. Utilising the FOCUS-DMAIC framework, the project included defining objectives, measuring baseline data, analysing root causes, implementing targetted interventions, and establishing monitoring mechanisms. Key interventions involve forming Wound Care Champions, introducing a Tissue Viability Nurse and Stoma Care Nurse, updating adhesive protocols, and conducting comprehensive training sessions. Pre-QIP metrics indicated an incidence rate of 0.33 MARSI per 1000 patient days, with nursing knowledge at 68 percent. Post-QIP results showed a significant reduction in MARSI to 0.18 per 1000 patient days and a knowledge increase to 95 percent. The incidence of MARSI decreased by 45 percent, exceeding the target reduction of 25 percent, and accurate adhesive usage improved from 55 percent to 96 percent. These findings highlight the effectiveness of structured training, standardisation of practices, and continuous monitoring in promoting patient safety. This project serves as a model for similar initiatives aiming to enhance care quality and mitigate MARSI in healthcare settings.