A prospective descriptive study was conducted on 121 pediatric patients with limb fractures indicated for cast immobilization who were treated at the Orthopedic Department of the National Children's Hospital from February to August 2024. The study aimed to identify factors associated with nursing care outcomes in these pediatric patients. Nursing care outcomes were assessed using eight monitoring and care criteria developed based on Henderson's 14 Basic Needs Theory and the Vietnamese Ministry of Health's Circular No. 07/2021/TT-BYT (Cronbach's alpha = 0.871). The Chi-square test was used to identify factors associated with nursing care outcomes, with statistical significance set at p < 0.05. The proportion of patients with good nursing care outcomes was 82.6%, while 17.4% had poor nursing care outcomes. The satisfaction rate of patients' families with nursing care was 90.9%. Factors significantly associated with poor nursing care outcomes included male sex (OR = 3.75; 95% CI: 1.27–11.04; p = 0.011), age ≥11 years (OR = 5.93; 95% CI: 1.54–22.85; p = 0.016), abnormal nutritional status (OR = 7.46; 95% CI: 2.50–22.24; p = 0.001), lower limb fractures (OR = 4.77; 95% CI: 1.73–13.09; p = 0.001), time from injury to hospital admission ≥24 hours (OR = 3.34; 95% CI: 1.13–9.83; p = 0.022), cast immobilization for ≥3 weeks (OR = 8.98; 95% CI: 1.15–69.90; p = 0.013), and a moderate level of family satisfaction with nursing care (OR = 4.89; 95% CI: 1.33–17.96; p = 0.009). Male sex, older age (≥11 years), abnormal nutritional status, lower limb fractures, delayed hospital admission, prolonged cast immobilization, and lower family satisfaction were significantly associated with poor nursing care outcomes among pediatric patients with limb fractures treated with cast immobilization.Objectives: To identify factors associated with nursing care outcomes among pediatric patients with limb fractures treated with cast immobilization at National Children's Hospital in 2024. Methods: A prospective observational study was conducted on 121 pediatric patients with limb fractures treated with cast immobilization from February to August 2024. Nursing care outcomes were assessed at cast removal using eight care criteria developed from Henderson's 14 Basic Needs and Circular No. 07/2021/TT-BYT (Cronbach's alpha=0.871); univariate associations were tested using the Chi-square or Fisher's exact test, with significance set at p<0.05. Results: The proportion of good nursing care outcomes was 82.6%; 90.9% of families reported satisfaction or high satisfaction. Factors significantly associated with poor outcomes on univariate analysis included male sex (crude OR=4.42; 95% CI: 1.50-13.01; p=0.011), age ≥11 years (crude OR=5.93; 95% CI: 1.54-22.85; p=0.016), abnormal BMI (crude OR=7.46; 95% CI: 2.50-22.24; p=0.001), lower limb fracture (crude OR=4.77; 95% CI: 1.73-13.09; p=0.001), admission ≥24 hours after injury (crude OR=3.34; 95% CI: 1.13-9.83; p=0.022), cast immobilization ≥3 weeks (crude OR=8.98; 95% CI: 1.15-69.90; p=0.013), and moderate family satisfaction (crude OR=4.89; 95% CI: 1.33-17.96; p=0.009). Conclusions: Male sex, older age, abnormal BMI, lower limb fracture, delayed admission, prolonged cast immobilization, and lower family satisfaction were associated with poor nursing care outcomes on univariate analysis; multivariable analysis is needed to identify independent risk factors.