A preliminary evaluation of an educational programme on bundle care knowledge among paediatric intensive care nurses: a single-group pre-post study

Hospital-acquired infections (HAIs) place critically ill children at serious risk and demand reliable infection-control practice. Care bundles group a small number of evidence-based measures for a specific infection and, applied consistently, help prevent HAIs. Because nurses deliver and monitor these measures at the bedside, their understanding of bundle care underpins implementation.

To evaluate, in a preliminary single-group study, whether a bundle care teaching programme changed paediatric intensive care unit (PICU) nurses' short-term knowledge of the bundles for central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infection (CAUTI), surgical site infection (SSI), and ventilator-associated pneumonia (VAP).

A single-group, pre-post design was used with 34 PICU nurses at a tertiary hospital in northern India. Nurses attended a one-day educational programme covering the four bundles. Knowledge was assessed before and after the programme with a 30-item, expert-reviewed questionnaire (Cronbach's α = 0.756). Within-participant change was analysed with Wilcoxon signed-rank tests, with effect sizes and 95% confidence intervals (CI); item-level McNemar tests were exploratory and Benjamini-Hochberg corrected. A pre-specified sensitivity analysis repeated every comparison on a reduced 25-item scale that excluded items subsequently judged not valid for paediatric practice as keyed. All 34 nurses completed both assessments.

Total knowledge increased by a mean of 8.18 points out of 30 (95% CI 6.62 to 9.85; median 8.0), a large within-participant change (Cohen's dz = 1.65). Scores increased across all four domains, with the largest gain in the VAP domain, which started lowest. On the reduced 25-item scale the gain remained large (mean + 6.24, 95% CI 4.79 to 7.68; dz = 1.42). At pre-test most nurses scored in the poor range; at post-test just over half reached the good range. Older, more experienced nurses had the lowest pre-test scores.

A one-day programme was associated with a large short-term gain in PICU nurses' knowledge of HAI prevention. Because the study measured knowledge in a single group without a comparator or clinical outcomes, testing, maturation, and regression to the mean cannot be excluded, and the findings show knowledge change rather than an effect on practice or infection rates. Hospitals should sustain education of this kind and, in future controlled work, link it to bundle compliance and HAI outcomes.