Knowledge translation following the implementation of a state-wide Paediatric Sepsis Pathway in the emergency department- a multi-centre survey study

Time Is Survival: Continuing Education on Sepsis for Neurosurgical Critical Care Nurses

BACKGROUND

Early identification of sepsis among neurosurgical critical care patients is a significant challenge because of the many possible confounding variables that lead to altered mental status in this specific patient population. Nurses' knowledge, attitudes, confidence, and practices related to the early identification and management of sepsis are crucial to patients' survival.

METHOD

This evidence-based intervention project implemented continuing education for neurosurgical critical care nurses on the early signs and symptoms of sepsis and the management of sepsis according to the Surviving Sepsis Campaign (SSC) Guidelines.

RESULTS

Continuing education on sepsis increased neurosurgical critical care nurses' knowledge of the SSC 1-hour sepsis bundle, reported confidence in the management of sepsis, and likelihood of assessing for sepsis.

CONCLUSION

Continuing education for neurosurgical critical care nurses on the signs and symptoms of sepsis and the SSC Guidelines is necessary and may improve patient outcomes. [J Contin Educ Nurs. 2024;55(5):224-230.].

Impact of parental and healthcare professional concern on the diagnosis of pediatric sepsis: a diagnostic accuracy study

Objective

The Surviving Sepsis Campaign recommends systematic screening for sepsis. Although many sepsis screening tools include parent or healthcare professional concern, there remains a lack of evidence to support this practice. We aimed to test the diagnostic accuracy of parent and healthcare professional concern in relation to illness severity, to diagnose sepsis in children.

Design

This prospective multicenter study measured the level of concern for illness severity as perceived by the parent, treating nurse and doctor using a cross-sectional survey. The primary outcome was sepsis, defined as a pSOFA score >0. The unadjusted area under receiver-operating characteristic curves (AUC) and adjusted Odds Ratios (aOR) were calculated.

Setting

Two specialised pediatric Emergency Departments in Queensland.

Patients

Children aged 30 days to 18 years old that were evaluated for sepsis.

Intervention

None.

Main Results

492 children were included in the study, of which 118 (23.9%) had sepsis. Parent concern was not associated with sepsis (AUC 0.53, 95% CI: 0.46-0.61, aOR: 1.18; 0.89-1.58) but was for PICU admission (OR: 1.88, 95% CI: 1.17-3.19) and bacterial infection (aOR: 1.47, 95% CI: 1.14-1.92). Healthcare professional concern was associated with sepsis in both unadjusted and adjusted models (nurses: AUC 0.57, 95% CI-0.50, 0.63, aOR: 1.29, 95% CI: 1.02-1.63; doctors: AUC 0.63, 95% CI: 0.55, 0.70, aOR: 1.61, 95% CI: 1.14-2.19).

Conclusions

While our study does not support the broad use of parent or healthcare professional concern in isolation as a pediatric sepsis screening tool, measures of concern may be valuable as an adjunct in combination with other clinical data to support sepsis recognition.

Clinical Trial Registration

ACTRN12620001340921.