Problem: A chart audit report from a 35-bed, level IV NICU, in the mid-Atlantic region found that 18 patients between January-June 2023, managed with headset continuous positive airway pressure (CPAP), had observable incidents of facial skin breakdown. No standardization of nursing care for infants on headset CPAP was in place. Purpose/Goals: This quality improvement project aimed to implement a care bundle to standardize nursing care and reduce skin breakdown in infants managed with the headset CPAP apparatus. Methods: A care bundle was created using evidence-based literature that supports five core elements: use of a preventative dressing, diligent and thorough skin assessment, rotation of mask and prongs, facial massage, and proper apparatus size selection. Education was provided, with a pre and post survey, on the bundle and desired documentation for all nursing staff. Weekly chart audits were performed over a 15-week intervention period. Data collected on 34 neonates was used to evaluate percentage of compliance to bundle elements and the percentage of documented skin breakdown over time. Results: Data analysis demonstrated documentation percentages for the following bundle elements: preventative dressing 90.3% (n=299), facial skin assessment 76.7% (n=254), mask and prong rotation 55% (n=182), facial massage 1.8% (n=6), and apparatus sizes 1.2% (n=4). The percentage of documented Neonatal Skin Condition Score (NSCS) of 3 (normal) on headset CPAP increased over time following initial implementation to 100%. Conclusion: The implementation of an evidence-based CPAP bundle may improve documentation of care as well as improve skin integrity.