Use of a Modified CVC Exit-Site Infection Score with a Prevention Bundle in Pediatric Care: An Evidence-Based Nursing Practice Project

Central venous catheters (CVCs) provide essential vascular access for pediatric patients but carry a risk of bloodstream infection (BSI). This evidence-based nursing practice project evaluated the use of a modified CVC exit-site infection score alongside a BSI prevention bundle among pediatric patients in the infectious disease ward at Dr. Cipto Mangunkusumo National Hospital, Jakarta. The quantitative study included 48 patients aged 1 month to 18 years with non-tunneled CVCs, recruited consecutively and allocated to intervention and control groups of 24 patients each. Over seven days, the intervention group received CVC monitoring and care using the modified score in combination with the prevention bundle. Outcomes included leukocyte count, procalcitonin, C-reactive protein, body temperature, exit-site score, and infection status. The authors reported a statistically significant difference in infection status associated with the intervention (p = 0.002) and a significant post-intervention difference between groups. These findings suggest that structured CVC monitoring and bundle-based care may support infection prevention in pediatric patients. Because the score and prevention bundle were implemented together, their individual contributions cannot be determined from the reported results.