Sepsis knowledge, skills and attitudes among ward-based nurses

Interprofessional Education Opportunities for Health Care Educators in the Practice Setting: An Integrative Review

INTRODUCTION

Health care educators in the practice setting are responsible for providing education to frontline staff and require knowledge and skills to interact with interprofessional health care providers and teach content in an effective way. Interprofessional education opportunities for health care educators in the practice setting may be helpful in preparing educators to meet the needs of frontline staff, yet the extant state of literature on this topic has not been recently synthesized. In this integrative review, we aimed to explore what is known about interprofessional education opportunities offered to health care educators who are responsible for educating other health care professionals in practice settings and assess how these education opportunities were described and evaluated in the literature.

METHODS

We conducted an integrative literature review following the methodology put forth by Toronto and Remington.

RESULTS

Of the 3690 publications identified, 30 met our inclusion criteria. Overall, the publications lacked rigorous methodology. Education interventions varied in content, duration, and teaching strategies. Key findings were identified: (1) educator satisfaction and content relevance, (2) impact on knowledge, skills, and confidence, (3) impact on teaching practice, (4) impact on clinical practice, (5) impact on interprofessional competencies and attitudes, (6) challenges to implementing interprofessional education opportunities, and (7) facilitators to implementing interprofessional education opportunities.

DISCUSSION

Although interprofessional education opportunities for health care educators in the practice setting may be beneficial to educators and the frontline staff they serve, more rigorous research is needed to understand how these opportunities can influence teaching and clinical practice.

Association of medical care capacity and the patient mortality of septic shock: a cross-sectional study

BACKGROUND

Hospitals with higher septic shock case volume demonstrated lower hospital mortality. We conducted this study to investigate whether this phenomenon was only caused by the increase in the number of admissions or the need to improve the medical care capacity in septic shock at the same time.

METHODS

Seven-hundred and eighty-seven hospitals from China collected in a survey from January 1, 2021 to December 31, 2021. Medical care capacity for septic shock was explored by patients with septic shock in intensive care units (ICU) divided into beds, intensivists, and nurses respectively.

MAIN RESULTS

The proportion of ICU patients with septic shock was negatively associated with the patient mortality of septic shock (Estimate [95%CI], -0.2532 [-0.5038, -0.0026]) (p-value 0.048). The ratios of patients with septic shock to beds, intensivists, and nurses were negatively associated with mortality of septic shock (Estimate [95%CI], -0.370 [-0.591, -0.150], -0.136 [-0.241, -0.031], and -0.774 [-1.158, -0.389]) (p-value 0.001, 0.011 and < 0.001). Severe pneumonia, the most common infection that caused a septic shock, correlated positively with its mortality (Estimate [95%CI], 0.1002 [0.0617, 0.1387]) (p-value < 0.001).

CONCLUSIONS

Hospitals with higher medical care capacity for septic shock were associated with lower hospital mortality.

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

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.

Knowledge and Associated Factors Towards Sepsis Management Among Nurses Working in the Emergency Department of Public Hospitals in Addis Ababa

Background

Sepsis is a major cause of mortality worldwide and an important public health problem. The quality of patient care is negatively impacted when nurses lack adequate knowledge regarding the management of sepsis. On the other hand, little is known regarding Ethiopian nurses' knowledge of sepsis management.

Objective

To assess the level of knowledge and the associated factors towards sepsis management among nurses working in emergency departments in public hospitals in Addis Ababa, Ethiopia.

Method

From March 18 to April 18, 2022, a health facility-based cross-sectional study was conducted. A simple sampling technique (lottery method) was used to select the hospitals. The data was analyzed using SPSS version 25. The study employed logistic regression analysis to examine the association between the independent variables and the level of knowledge. Variables were significantly associated with a level of knowledge if they had a p-value of less than 0.05 and a 95% confidence interval.

Result

Of the 127 participants, more than half (56.7%) had poor knowledge. Nurses' knowledge of managing sepsis was significantly associated with not having regular training, a low level of education, and working experience of less than five years. The findings of the multivariable regression analysis revealed that the following variables were associated with a nurse's knowledge of sepsis management: low level of education (AOR = 3.2 (95% CI, 1.16-8.77), lack of training adjusted odd ratio (AOR = 2.5 (95% CI, 1.07-5.93), and less than five years of work experience (AOR = 3.6 (95% CI, 1. 29-9.830).

Conclusion

The majority of nurses had inadequate knowledge of managing sepsis. On the other hand, the majority of nurses had a favourable attitude toward sepsis management. Lack of prior training, a low level of education, and less than five years of work experience were all significantly associated with nurses' poor knowledge regarding sepsis management. This study recommends that hospital managers should provide on-the-job and long-term training for nurses working in the emergency department to enhance the level of nurses' knowledge towards sepsis management at their institutions.

Nurses' knowledge and confidence in recognizing and managing patients with sepsis: A multi-site cross-sectional study

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.

Sepsis assessment and management in critically Ill adults: A systematic review

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.