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Yue J, Zhao H, Li J, Wu J, Zheng R. Knowledge, attitudes and practices towards the diagnosis and management of paediatric sepsis among paediatric physicians and nurses: a cross-sectional study of 21 hospitals in Hubei Province, China. BMJ Open 2024; 14:e079411. [PMID: 38417965 PMCID: PMC10900314 DOI: 10.1136/bmjopen-2023-079411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 02/14/2024] [Indexed: 03/01/2024] Open
Abstract
OBJECTIVES To evaluate the knowledge, attitudes and practices towards diagnosing and managing paediatric sepsis among paediatric physicians and nurses. DESIGN A cross-sectional, questionnaire-based study. SETTING 21 hospitals in Hubei Province between February 2023 and March 2023. PARTICIPANTS Paediatric physicians and nurses. INTERVENTIONS None. PRIMARY AND SECONDARY OUTCOME MEASURES The questionnaire contained 35 items across four dimensions (demographic information, knowledge, attitude and practice). RESULTS The study included 295 participants (173 women). The average knowledge, attitude and practice scores were 10.93±2.61 points (possible range, 0-20 points), 32.22±2.65 points (possible range, 7-35 points) and 36.54±5.24 points (possible range, 9-45 points), respectively. Knowledge had a direct influence on both attitude (β=0.240, 95% CI 0.136 to 0.365, p=0.009) and practice (β=0.278, 95% CI 0.084 to 0.513, p=0.010), which also indirectly influenced practice through attitude (β=0.162, 95% CI 0.078 to 0.290, p=0.007). Attitude directly influenced practice (β=0.677, 95% CI 0.384 to 0.902, p=0.025). A higher attitude score was associated with good practice (OR=1.392; 95% CI 1.231 to 1.576; p<0.001), while not working in a tertiary hospital reduced the odds of good practice (OR=0.443; 95% CI 0.2390.821; p=0.010). CONCLUSIONS The knowledge regarding paediatric sepsis, especially knowledge about sepsis management, is poor among paediatric physicians and nurses in Hubei Province. The findings of this study may facilitate the development and implementation of training programmes to improve the diagnosis and management of paediatric sepsis.
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Affiliation(s)
- Jing Yue
- Department of Emergence, Hubei Province Women and Children Hospital, Wuhan, Hubei, China
| | - Hui Zhao
- Department of Emergence, Hubei Province Women and Children Hospital, Wuhan, Hubei, China
| | - Jie Li
- Department of Emergence, Hubei Province Women and Children Hospital, Wuhan, Hubei, China
| | - Jiannan Wu
- Department of Emergence, Hubei Province Women and Children Hospital, Wuhan, Hubei, China
| | - Ronghao Zheng
- Department of Pediatric Nephrology, Rheumatology, and Immunology, Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei, China
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Regina J, Le Pogam MA, Niemi T, Akrour R, Pepe S, Lehn I, Wasserfallen JB, Calandra T, Meylan S. Sepsis awareness and knowledge amongst nurses, physicians and paramedics of a tertiary care center in Switzerland: A survey-based cross-sectional study. PLoS One 2023; 18:e0285151. [PMID: 37379303 DOI: 10.1371/journal.pone.0285151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 04/06/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Sepsis is a leading cause of morbidity and mortality. Prompt recognition and management are critical to improve outcomes. METHODS We conducted a survey among nurses and physicians of all adult departments of the Lausanne University Hospital (LUH) and paramedics transporting patients to our hospital. Measured outcomes included professionals' demographics (age, profession, seniority, unit of activity), quantification of prior sepsis education, self-evaluation, and knowledge of sepsis epidemiology, definition, recognition, and management. Correlation between surveyed personnel and sepsis perceptions and knowledge were assessed with univariable and multivariable logistic regression models. RESULTS Between January and October 2020, we contacted 1'216 of the 4'417 professionals (27.5%) of the LUH, of whom 1'116 (91.8%) completed the survey, including 619 of 2'463 (25.1%) nurses, 348 of 1'664 (20.9%) physicians and 149 of 290 (51.4%) paramedics. While 98.5% of the participants were familiar with the word "sepsis" (97.4% of nurses, 100% of physicians and 99.3% of paramedics), only 13% of them (physicians: 28.4%, nurses: 5.9%, paramedics: 6.8%) correctly identified the Sepsis-3 consensus definition. Similarly, only 48% and 49.3% of the physicians and 10.1% an 11.9% of the nurses knew that SOFA was a sepsis defining score and that the qSOFA score was a predictor of increased mortality, respectively. Furthermore, 15.8% of the physicians and 1.0% of the nurses knew the three components of the qSOFA score. For patients with suspected sepsis, 96.1%, 91.6% and 75.8% of physicians respectively chose blood cultures, broad-spectrum antibiotics and fluid resuscitation as therapeutic interventions to be initiated within 1 (76.4%) to 3 (18.2%) hours. For nurses and physicians, recent training correlated with knowledge of SOFA score (ORs [95%CI]: 3.956 [2.018-7.752] and 2.617 [1.527-4.485]) and qSOFA (ORs [95%CI]: 5.804 [2.653-9.742] and 2.291 [1.342-3.910]) scores purposes. Furthermore, recent training also correlated with adequate sepsis definition (ORs [95%CI]: 1.839 [1.026-3.295]) and the components of qSOFA (ORs [95%CI]: 2.388 [1.110-5.136]) in physicians. CONCLUSIONS This sepsis survey conducted among physicians, nurses and paramedics of a tertiary Swiss medical center identified a deficit of sepsis awareness and knowledge reflecting a lack of sepsis-specific continuing education requiring immediate corrective measures.
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Affiliation(s)
- Jean Regina
- Department of Medicine, Infectious Diseases Service, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Marie-Annick Le Pogam
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Tapio Niemi
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Rachid Akrour
- Service of Geriatrics and Geriatric Rehabilitation, Lausanne University Hospital, Lausanne, Switzerland
| | - Santino Pepe
- Medical Directorate, Lausanne University Hospital, Lausanne, Switzerland
| | - Isabelle Lehn
- Director of Nursing, Lausanne University Hospital, Lausanne, Switzerland
| | | | - Thierry Calandra
- Department of Medicine, Infectious Diseases Service, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- Department of Medicine and Department of Laboratory Medicine and Pathology, Service of Immunology and Allergy, Center for Human Immunology Lausanne, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
- Department of Infectious Diseases and Tropical Medicine, Necker-Enfants Malades University Hospital, University of Paris Cité, Paris, France
| | - Sylvain Meylan
- Department of Medicine, Infectious Diseases Service, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
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Chua WL, Teh CS, Basri MABA, Ong ST, Phang NQQ, Goh EL. Nurses' knowledge and confidence in recognizing and managing patients with sepsis: A multi-site cross-sectional study. J Adv Nurs 2023; 79:616-629. [PMID: 36069994 PMCID: PMC10087790 DOI: 10.1111/jan.15435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/26/2022] [Accepted: 08/20/2022] [Indexed: 01/26/2023]
Abstract
AIMS (1) To examine registered nurses' knowledge and confidence in recognizing and managing to patients with sepsis and (2) identify nurse and workplace factors that influence their knowledge on sepsis. DESIGN A multi-site, cross-sectional survey. METHODS An online survey was developed and content validated. Data was collected from registered nurses working in the inpatient wards and emergency departments of three hospitals of a single healthcare cluster in Singapore during August 2021. Statistical analyses of closed-ended responses and content analysis of open-ended responses were undertaken. RESULTS A total of 709 nurses completed the survey. Nurses possessed moderate levels of knowledge about sepsis (mean score = 10.56/15; SD = 2.01) and confidence in recognizing and responding to patients with sepsis (mean score = 18.46/25; SD = 2.79). However, only 369 (52.0%) could correctly define sepsis. Nurses' job grade, nursing education level and clinical work area were significant predictors of nurses' sepsis knowledge. Specifically, nurses with higher job grade, higher nursing education level or those working in acute care areas (i.e. emergency department, high dependency units or intensive care units) were more likely to obtain higher total sepsis knowledge scores. A weak positive correlation was observed between sepsis knowledge test scores and self-confidence (r = .184). Open comments revealed that participants desired for more sepsis education and training opportunities and the implementation of sepsis screening tool and sepsis care protocol. CONCLUSION A stronger foundation in sepsis education and training programs and the implementation of sepsis screening tools and care bundles are needed to enhance nurses' knowledge and confidence in recognizing and managing patients with sepsis. IMPACT The findings of this study are beneficial to administrators, educators and researchers in designing interventions to support nurses in their role in recognizing and responding to sepsis.
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Affiliation(s)
- Wei Ling Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore
| | - Chin Shim Teh
- Nursing Department, Alexandra Hospital, National University Health System, Singapore City, Singapore
| | | | - Shi Ting Ong
- Nursing Department, National University Hospital, National University Health System, Singapore City, Singapore
| | - Noel Qiao Qi Phang
- Nursing Department, Ng Teng Fong General Hospital, National University Health System, Singapore City, Singapore
| | - Ee Ling Goh
- Department of Emergency Medicine, Ng Teng Fong General Hospital, National University Health System, Singapore City, Singapore
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Jessen MK, Simonsen BY, Thomsen MH, Andersen LW, Kolsen‐Petersen JA, Kirkegaard H. Fluid management of emergency department patients with sepsis-A survey of fluid resuscitation practices. Acta Anaesthesiol Scand 2022; 66:1237-1246. [PMID: 36054552 PMCID: PMC9805143 DOI: 10.1111/aas.14141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/03/2022] [Accepted: 08/10/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Fluid administration and resuscitation of patients with sepsis admitted through emergency departments (ED) remains a challenge, and evidence is sparse especially in sepsis patients without shock. We aimed to investigate emergency medicine physicians' and nurses' perceptions, self-reported decision-making and daily behavior, and challenges in fluid administration of ED sepsis patients. METHODS We developed and conducted a multicenter, web-based, cross-sectional survey focusing on fluid administration to ED patients with sepsis sent to all nurses and physicians from the five EDs in the Central Denmark Region. The survey consisted of three sections: (1) baseline information; (2) perceptions of fluid administration and daily practice; and (3) clinical scenarios about fluid administration. The survey was performed from February to June, 2021. RESULTS In total, 138 of 246 physicians (56%) and 382 of 595 nurses (64%) responded to the survey. Of total, 94% of physicians and 97% of nurses regarded fluid as an important part of sepsis treatment. Of total, 80% of physicians and 61% of nurses faced challenges regarding fluid administration in the ED, and decisions were usually based on clinical judgment. The most common challenge was the lack of guidelines for fluid administration. Of total, 96% agreed that they would like to learn more about fluid administration, and 53% requested research in fluid administration of patients with sepsis. For a normotensive patient with sepsis, 46% of physicians and 44% of nurses administered 1000 ml fluid in the first hour. Of total, 95% of physicians and 89% of nurses preferred to administer ≥1000 ml within an hour if the patients' blood pressure was 95/60 at admission. There was marked variability in responses. Blood pressure was the most commonly used trigger for fluid administration. Respondents preferred to administer less fluid if the patient in the scenario had known renal impairment or heart failure. Normal saline was the preferred fluid. CONCLUSION Fluid administration is regarded as an important but challenging aspect of sepsis management. Responses to scenarios revealed variability in fluid volumes. Blood pressure was the most used trigger. ED nurses and physicians request evidence-based guidelines to improve fluid administration.
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Affiliation(s)
- Marie Kristine Jessen
- Research Center for Emergency Medicine, Department of Clinical MedicineAarhus University and Aarhus University HospitalAarhusDenmark,Department of Emergency MedicineAarhus University HospitalAarhusDenmark
| | - Birgitte Y. Simonsen
- Research Center for Emergency Medicine, Department of Clinical MedicineAarhus University and Aarhus University HospitalAarhusDenmark
| | | | - Lars W. Andersen
- Research Center for Emergency Medicine, Department of Clinical MedicineAarhus University and Aarhus University HospitalAarhusDenmark,Department of Anesthesiology and Intensive CareAarhus University HospitalAarhusDenmark,Prehospital Emergency Medical ServicesCentral Denmark RegionAarhusDenmark
| | | | - Hans Kirkegaard
- Research Center for Emergency Medicine, Department of Clinical MedicineAarhus University and Aarhus University HospitalAarhusDenmark
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Rababa M, Bani-Hamad D, Hayajneh AA, Al Mugheed K. Nurses’ knowledge, attitudes, practice, and decision-making skills related to sepsis assessment and management. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2022. [DOI: 10.29333/ejgm/12556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
<b>Objectives</b>: The present study examines the critical care nurse’s knowledge, attitudes, practice (KAP), and decision-making related to early assessment and management of sepsis.<br />
<b>Methods</b>: This cross-sectional descriptive study utilized a convenience sample of 70 nurses working in a college hospital in the northern region of Jordan. Data were gathered employing a sepsis vignette and valid questionnaires via Google document. The nursing decision-making instrument and the knowledge, attitudes, and practice survey were utilized to assess nurses’ decision-making skills, knowledge, attitudes, and practice, respectively. Nurses’ sociodemographic/professional data, including gender, marital status, experience, education, and work environment, were also measured.<br />
<b>Result</b>: The participating nurses reported poor KAP, and analytical decision-making skills related to sepsis management. Experienced nurses and those with a master’s degree reported significantly better KAP, and intuitive decision-making skills than naïve and those with a bachelor’s degree. Nurses with analytical decision-making modes reported higher levels of knowledge, attitudes, and practice than nurses with intuitive or flexible analytical-intuitive decision-making modes.<br />
<b>Conclusion</b>: Poor decision-making skills, as well as knowledge, attitudes, and practice related to sepsis assessment and management, is a substantial problem that demands a productive re-evaluation of the current sepsis management practices. Boosting the knowledge and improving the practices on sepsis assessment and management through comprehensive educational programs and campaigns are necessary to improve nurses’ decision-making skills.
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Affiliation(s)
- Mohammad Rababa
- Department of Adult Health Nursing Faculty of Nursing, Jordan University of Science and Technology, Irbid, JORDAN
| | - Dania Bani-Hamad
- Department of Adult Health Nursing Faculty of Nursing, Jordan University of Science and Technology, Irbid, JORDAN
| | - Audai A Hayajneh
- Department of Adult Health Nursing Faculty of Nursing, Jordan University of Science and Technology, Irbid, JORDAN
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Prompt Identification of Sepsis on Hospital Floors: Are Healthcare Professionals Ready for the Implementation of the Hour-1 Bundle? Trop Med Infect Dis 2022; 7:tropicalmed7100291. [PMID: 36288032 PMCID: PMC9608946 DOI: 10.3390/tropicalmed7100291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/21/2022] [Accepted: 10/08/2022] [Indexed: 11/17/2022] Open
Abstract
Early intervention in sepsis management with recognized therapeutic targets may be effective in lowering sepsis-related morbidity and mortality, although this necessitates timely identification of sepsis by healthcare professionals. The present study aimed to assess knowledge levels, attitudes, and agreement among physicians regarding the Surviving Sepsis Campaign (SSC) guidelines (more specifically, the Hour-1 bundle). A quantitative, descriptive, cross-sectional study was conducted among physicians working in different clinical settings in Karachi, Pakistan, using a self-administered questionnaire. The mean cumulative knowledge score of the respondents towards SSC was 6.8 ± 2.1 (out of 10), where a total of n = 127 respondents (51.62%) had a strong understanding of the SSC guidelines, compared to n = 78 (31.7%) and n = 41 (16.7%) respondents with fair and inadequate knowledge, respectively. The majorly known bundle elements by the respondents were to administer broad-spectrum antibiotics (89.8%, n = 221), the need for taking blood cultures before administering antibiotics (87.8%, n = 216), and measurement of blood lactate levels (75.6%, n = 186). Experienced physicians were more likely to use norepinephrine as the first-choice vasopressor (p < 0.001). Female respondents were more likely to consider the duration of antibiotic therapy to be determined according to the site of infection, the microbiological etiology, the patient’s response to treatment, and the likelihood of achieving adequate source control (p = 0.001). The current study concluded that respondents had an optimistic approach and frequently practice in accordance with the SSC guidelines, while some respondents were not up to date with the most recent guidelines. There is a need for further interventions and continuous medical education to encourage physicians towards appropriate use of the recommended guiding principles for improving treatment outcomes in sepsis patients.
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Rababa M, Bani Hamad D, Hayajneh AA. Sepsis assessment and management in critically Ill adults: A systematic review. PLoS One 2022; 17:e0270711. [PMID: 35776738 PMCID: PMC9249173 DOI: 10.1371/journal.pone.0270711] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 06/14/2022] [Indexed: 12/15/2022] Open
Abstract
Background
Early assessment and management of patients with sepsis can significantly reduce its high mortality rates and improve patient outcomes and quality of life.
Objectives
The purposes of this review are to: (1) explore nurses’ knowledge, attitude, practice, and perceived barriers and facilitators related to early recognition and management of sepsis, (2) explore different interventions directed at nurses to improve sepsis management.
Methods
A systematic review method according to the PRISMA guidelines was used. An electronic search was conducted in March 2021 on several databases using combinations of keywords. Two researchers independently selected and screened the articles according to the eligibility criteria.
Results
Nurses reported an adequate of knowledge in certain areas of sepsis assessment and management in critically ill adult patients. Also, nurses’ attitudes toward sepsis assessment and management were positive in general, but they reported some misconceptions regarding antibiotic use for patients with sepsis, and that sepsis was inevitable for critically ill adult patients. Furthermore, nurses reported they either were not well-prepared or confident enough to effectively recognize and promptly manage sepsis. Also, there are different kinds of nurses’ perceived barriers and facilitators related to sepsis assessment and management: nurse, patient, physician, and system-related. There are different interventions directed at nurses to help in improving nurses’ knowledge, attitudes, and practice of sepsis assessment and management. These interventions include education sessions, simulation, decision support or screening tools for sepsis, and evidence-based treatment protocols/guidelines.
Discussion
Our findings could help hospital managers in developing continuous education and staff development training programs on assessing and managing sepsis in critical care patients.
Conclusion
Nurses have poor to good knowledge, practices, and attitudes toward sepsis as well as report many barriers related to sepsis management in adult critically ill patients. Despite all education interventions, no study has collectively targeted critical care nurses’ knowledge, attitudes, and practice of sepsis management.
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Affiliation(s)
- Mohammad Rababa
- Adult Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
- * E-mail:
| | - Dania Bani Hamad
- Adult Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Audai A. Hayajneh
- Adult Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
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Rababa M, Bani-Hamad D, Hayajneh AA. The effectiveness of branching simulations in improving nurses' knowledge, attitudes, practice, and decision-making related to sepsis assessment and management. NURSE EDUCATION TODAY 2022; 110:105270. [PMID: 35051870 DOI: 10.1016/j.nedt.2022.105270] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 12/15/2021] [Accepted: 01/09/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Nurses have a key role in the early assessment and management of sepsis, which is crucial for optimal quality of care and better patient outcomes. However, sepsis in critical care patients is underrecognized and untreated due to nurses' poor knowledge, attitudes, practice, and decision-making skills related to sepsis assessment and management. OBJECTIVES This study aimed to test the effectiveness of branching simulations in improving nurses' knowledge, attitudes, practices, and decision-making related to sepsis assessment and management. METHODS This experimental study was conducted on a convenience sample of 70 nurses (35 nurses in each of the intervention and control groups) with at least one year of experience working in an emergency room at a university hospital. The nurses' knowledge, attitudes, and practices were measured using a knowledge, attitudes, and practices survey, whilst their decision-making modes were assessed using the Nursing Decision-Making Instrument. RESULTS Compared to the control group, a significant improvement in practices (F (1, 68) = 10.77, p = 0.002, η2 = 0.137) and decision-making (F (1, 68) = 10.68, p = 0.002, η2 = 0.136) was observed among the nurses in the intervention group both immediately and two weeks post the branching simulations intervention. Compared to the baseline data, a significant improvement in knowledge (F (2, 136) = 27.93, p < 0.001, η2 = 0.291), practices (F (2, 136) = 41.00, p < 0.001, η2 = 0.376), and decision-making modes (F (2, 136) = 29.15, p < 0.001, η2 = 0.300) was observed both immediately and two weeks post branching simulations only among the nurses in the intervention group. CONCLUSIONS Education programs integrated with an interactive strategy of learning (branching simulations) can improve nurses' knowledge, attitude, practice, and decision-making related to sepsis assessment and management. Therefore, continuous education and professional training programs following an evidence-based intervention protocol/guideline are recommended for better nurse and patient outcomes.
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Affiliation(s)
- Mohammad Rababa
- Department of Adult Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid 22110, Jordan.
| | - Dania Bani-Hamad
- Department of Adult Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Audai A Hayajneh
- Department of Adult Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid 22110, Jordan
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Salameh B, Aboamash AEM. Predictors of Knowledge, Attitudes, Practices and Barriers Regarding Sepsis and Sepsis Management Among Emergency Nurses and Physicians in Palestine: A Cross-Sectional Analysis. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221115265. [PMID: 35932110 PMCID: PMC9364222 DOI: 10.1177/00469580221115265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sepsis is a widespread problem that can create clinical and economic
difficulties. This study aimed to determine the knowledge, attitudes, practices,
and barriers related to the sepsis and sepsis management among emergency nurses
and physicians. Data was collected using a self-questionnaire completed by the
participating nurses and physicians (n = 243), with a 61% response rate. The
study found that both emergency nurses and physicians had poor-to-moderate
levels of sepsis knowledge, with emergency physicians having better attitudes
regarding sepsis and sepsis management than emergency nurses. However, moderate
knowledge levels of sepsis practice and management were shown among both nurses
and physicians. It is evident that for emergency nurses and physicians, the
biggest barrier to providing quality care to patients with sepsis is the lack of
monitoring equipment. Both nurses and physicians need consistent sepsis
management information provided by continual education programs. Development of
an approved protocol can improve nurses’ knowledge, attitudes, and
practices.
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Adegbite BR, Edoa JR, Rylance J, Jacob ST, Kawale P, Adegnika AA, Grobusch MP. Knowledge of health workers relating to sepsis awareness and management in Lambaréné, Gabon. Acta Trop 2021; 219:105914. [PMID: 33831345 DOI: 10.1016/j.actatropica.2021.105914] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 03/25/2021] [Accepted: 03/29/2021] [Indexed: 12/29/2022]
Abstract
Background In 2016, the third international consensus definitions for sepsis and septic shock (Sepsis-3) task force provided revised definitions for sepsis and septic shock. This study explores knowledge regarding sepsis among health workers in Lambaréné, Gabon. Methods We conducted a self-administered questionnaire-based survey about sepsis among health workers from the referral regional hospital, the research center, and primary care health facilities in the Lambaréné region. Participants were from the referral regional hospital, the research center, and primary health care facilities. A score of one was given to each correct answer. The global score out of a possible score of twenty was calculated, and the proportion of correct responses was determined. Results A total of 115 health workers (physicians, nurses and assistant nurses) completed the questionnaire, of which 48.7% (56/115) provided a valid definition of sepsis, but 74% (85/115) had never heard about the quick Sequential Organ Failure Assessment (qSOFA) score. The proportion of correct answers was comparable across the three health profession categories. The median global score across all health workers was 11 [IQR, 9-14.5] out of 20. Physicians attained higher global scores [14 (IQR, 11-15)] than assistant nurses [11 (IQR, 8-13), P=0.007]; their global score was comparable to that of nurses. Conclusion There are considerable knowledge gaps regarding sepsis among health workers in Lambaréné, potentially impairing the prompt recognition and management of sepsis. There is a need to establish periodic up-to-date training to improve sepsis knowledge.
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Li B, Zhang F, Li H. miR-1225-5p inhibits non-small cell lung cancer cell proliferation, migration and invasion, and may be a prognostic biomarker. Exp Ther Med 2020; 20:172. [PMID: 33101465 PMCID: PMC7579767 DOI: 10.3892/etm.2020.9302] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 08/08/2020] [Indexed: 12/13/2022] Open
Abstract
Non-small cell lung cancer (NSCLC) is a malignant tumor, which presents with a high 5-year mortality rate owing to the lack of an effective early screening tool and the absence of obvious early symptoms. MicroRNAs (miRs/miRNAs) have attracted increasing attention due to their significant clinical value in the diagnosis and prognosis of various human malignancies. The present study aimed to investigate the expression levels of microRNA (miR)-1225-5p in NSCLC and to analyze its prognostic value and biological role. The expression levels of miR-1225-5p in the tissues of patients with NSCLC and NSCLC cell lines were analyzed using reverse transcription-quantitative PCR. The association between miR-1225-5p expression levels and the clinicopathological features of patients with NSCLC was analyzed using a χ2 test. The prognostic value of miR-1225-5p in NSCLC was analyzed using both Kaplan Meier survival and Cox regression analyses, and the effects of miR-1225-5p on NSCLC cell proliferation, migration and invasion were examined. The results revealed that the expression levels of miR-1225-5p were significantly downregulated in NSCLC tissues compared with normal control tissues. Furthermore, miR-1225-5p was discovered to be a potential independent prognostic factor in NSCLC. The inhibition of miR-1225-5p in NSCLC cell lines led to increased cell proliferation, migration and invasion, whereas miR-1225-5p overexpression exerted the opposite effects in these cells. In conclusion, the findings of the present study indicated that the downregulated expression levels of miR-1225-5p in NSCLC may predict a poor prognosis in patients and suggested miR-1225-5p as a potential therapeutic target for NSCLC.
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Affiliation(s)
- Bin Li
- Department of Respiratory Medicine, Shouguang People's Hospital, Shouguang, Shandong 262700, P.R. China
| | - Fengmin Zhang
- Department of Obstetrics, Shouguang People's Hospital, Shouguang, Shandong 262700, P.R. China
| | - Hong Li
- Department of Public Health, Shouguang People's Hospital, Shouguang, Shandong 262700, P.R. China
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Diagnostic Value of miR-103 in Patients with Sepsis and Noninfectious SIRS and Its Regulatory Role in LPS-Induced Inflammatory Response by Targeting TLR4. Int J Genomics 2020; 2020:2198308. [PMID: 32455124 PMCID: PMC7243004 DOI: 10.1155/2020/2198308] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 04/28/2020] [Indexed: 12/16/2022] Open
Abstract
Background Sepsis is a life-threatening condition and a systemic inflammatory response syndrome (SIRS) driven by infection. This study aimed at investigating the expression of microRNA-103 (miR-103) in sepsis patients, evaluating its diagnostic value, and exploring the regulatory effect of miR-103 on LPS-induced inflammation in monocytes. Methods Expression of miR-103 was measured using quantitative real-time PCR. A receiver operating characteristics curve was plotted to evaluate the diagnostic vale of miR-103. Serum and cell supernatant levels of proinflammatory cytokines were analyzed using ELISA. The interaction between miR-103 and Toll-like receptors 4 (TLR4) was analyzed using luciferase reporter assay. The effect of miR-103 on inflammation was examined in LPS-treated monocytes. Results Serum expression of miR-103 was decreased in noninfectious SIRS and sepsis patients compared with healthy controls, and the lowest expression value was observed in sepsis patients (all P < 0.05). Serum levels of miR-103 have considerable diagnostic accuracy in distinguishing sepsis patients from SIRS patients and healthy controls. A negative correlation was found between miR-103 and inflammatory responses in sepsis patients. TLR4 was demonstrated to be a direct target of miR-103 and was negatively regulated by miR-103 in monocytes. The promoted inflammatory responses by LPS in monocytes were reversed by the overexpression of miR-103. Conclusion All the data revealed that serum decreased miR-103 in sepsis patients serves as a promising noninvasive diagnostic biomarker and may be involved in the pathogenesis of sepsis by regulating inflammatory responses via targeting TLR4.
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