Background: Infections leading to sepsis are major contributors to mortality and morbidity in children world-wide. Determining the capacity of pediatric hospitals in Nigeria to manage sepsis establishes an important baseline for quality-improvement interventions and resource allocations. Objectives: To assess the availability and functionality of resources and manpower for early detection and prompt management of sepsis in children at tertiary pediatric centers in Nigeria. Methods: This was an online survey of tertiary pediatric hospitals in Nigeria using a modified survey tool designed by the World Federation of Pediatric Intensive and Critical Care Societies (WFPICCS). The survey addressed all aspects of pediatric sepsis identification, management, barriers and readiness. Results: While majority of the hospitals 97% (28/29) reported having adequate triage systems, only 60% (16/27) follow some form of guideline for sepsis management. There was no consensus national guideline for management of pediatric sepsis. Over 50% of the respondents identified deficit in parental education, poor access to healthcare services, failure to diagnose sepsis at referring institutions, lack of medical equipment and lack of a definitive protocol for managing pediatric sepsis, as significant barriers. Conclusions: Certain sepsis-related interventions were reportedly widespread, however, there is no standardized sepsis protocol, and majority of the hospitals do not have pediatric intensive care units (PICU). These findings could guide quality improvement measures at institutional level, and healthcare policy/spending at the national level.

Nigerian nurse intensivists are under the regulation of the National Association of Nurses and Midwives Nigeria and critical care units are based within departments of anaesthesia. The scarcity of trained nurse intensivists is made worse by the brain drain to the West. Intensive care nursing, in the Nigerian context, is demanding, carries a high workload, and is stressful for nursing staff.

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Africa is one of the poorest continents in the world and has immature critical care services compared to countries in the developed world. •Critical care nursing leaders in the region have been on a 10-year journey to form a sustainable network and strategy to improve critical care. •This paper tells the story associated with the formation and development of a multi-national critical care nursing organisation in the African region, which is now known as the African Federation of Critical Care Nurses.

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