The model of early rehabilitation for people with burns is still relatively novel in developing countries such as Egypt. The study examined the effect of a nurse-led rehabilitation program on functional outcomes in patients with severe hand burns. A quasi-experimental design was used in this study. The study was completed in the burn unit of a teaching university hospital in Alexandria, Egypt, with a convenience sample of 80 patients with severe hand burns. Participants were consecutively assigned to one of two groups: control ( n = 40), which received only routine hospital care and clinical interventions, or intervention ( n = 40), which received routine hospital care and clinical interventions and a 4-week nurse-led rehabilitation program (health education including audiovisual aids and burn rehabilitation education booklet, social support, and hand rehabilitation exercises). To assess functional outcomes, both groups were given pre- and posttests of the Disabilities of the Arm, Shoulder and Hand outcome and the Hand Motor Function Observational Checklist questionnaires. Descriptive and inferential statistics were conducted. Functional outcomes were significantly improved in the intervention participants compared to the control participants ( t = 5.710, p < .001). The differences in index scores between the two groups were statistically significant ( p < .001). The study provides information for burn rehabilitation nurses in developing countries to develop and test early interventions that improve functional outcomes in this population. A 4-week nurse-led program may be a beneficial intervention for improving functional outcomes in adult patients with severe hand burns who are undergoing rehabilitation.