Barriers to implementing the Sepsis Six guidelines in an acute hospital setting

Breen, Sarah-Jane; Rees, Sharon

doi:10.12968/bjon.2018.27.9.473

Cited by 17 publications

(32 citation statements)

References 10 publications

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“…Even among those who had received training in these skills, many did not use them. Another study by Breen and Rees (2018) found that ward nurses were significantly more likely to lack these skills compared to ED nurses. A lack of the necessary skills, or a reluctance to use them, places patients at risk of deteriorating if there is a delay in obtaining intravenous access to administer appropriate antibiotics and fluids.…”

Section: Discussionmentioning

confidence: 99%

“…Undertaking all the steps required to complete the sepsis six within one hour is challenging. Barriers include nurses' skills, staff shortages, distractions, poor communication and delay in the prescribing of antibiotics (Matthaeus-Kraemer et al 2016;Tarrant et al 2016;Roberts et al 2017a;Roberts et al 2017b;Breen and Rees 2018). Although a lack of training has been identified as a barrier to implementation of the sepsis bundle (Roberts et al 2017a), few studies have evaluated the effects of sepsis training.…”

Section: Introductionmentioning

confidence: 99%

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Sepsis knowledge, skills and attitudes among ward-based nurses

Edwards

Jones

2021

Br J Nurs

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Background: Nurses are in a prime position to identify sepsis early by screening patients for sepsis, a skill that should be embedded into their daily practice. However, compliance with the sepsis bundle remains low. Aims: To explore the effects of sepsis training on knowledge, skills and attitude among ward-based nurses. Methods: Registered nurses from 16 acute surgical and medical wards were invited to anonymously complete a questionnaire. Findings: Response rate was 39% (98/250). Nurses with sepsis training had better knowledge of the National Early Warning Score 2 for sepsis screening, and the systemic inflammatory response syndrome (SIRS) criteria, demonstrated a more positive attitude towards sepsis screening and management, were more confident in screening patients for sepsis and more likely to have screened a patient for sepsis. Conclusions: Sepsis training improves nurses' attitudes, knowledge and confidence with regards to sepsis screening and management, resulting in adherence to evidence-based care, and should become mandatory for all clinical staff.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sepsis knowledge, skills and attitudes among ward-based nurses

Edwards

Jones

2021

Br J Nurs

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“…A study [21] found that doctors and nurses demonstrated difficulty in identifying septic patients. Results of a cross sectional descriptive study using a self-completed questionnaire given to doctors and nurses related to sepsis identification, principles, resources, skill and education demonstrated that there was a lack of adequate nursing staff, and resources to deliver interventions within the hour [22][23][24][25][26][27][28][29][30].…”

Section: Discussionmentioning

confidence: 99%

Implementation of the 1-Hour Sepsis Bundle and Evaluation of Staff Adherence: An Evidence-based Practice Quality Improvement Project

2021

Integr J Nurs Med

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the SSC developed the 1-hour sepsis bundle because the 3-hour window was associated with a significant increase in in-hospital mortality [3]. The bundle calls for lactate measures, blood cultures, antibiotics, if appropriate fluid resuscitation and vasopressors within 1-hour of sepsis recognition [3]. In 2015, The Centers for Medicare and Medicaid implemented its core bundle measure for Severe Sepsis and Septic Shock Early Management Bundle linking reimbursement to a hospitals' ability to complete the SSC bundle interventions within 3 hours of sepsis recognition [4]. To help meet this quality measure, hospitals may benefit from initiatives aimed at improving the process of sepsis care and bundle completion within the 1 to 3-hour window. Meeting the SSC's 1-hour implementation goal can be challenging. Historically, nurses have been responsible for initiating a sepsis protocol [5]. There are tools to facilitate timely initiation of bundle interventions [6]. The emergency room nurse sepsis screening tool significantly improved the time to bundle completion in patient's diagnoses with severe sepsis and septic shock [7]. The nurse initiated emergency department sepsis protocol significantly reduced time to

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“…Some factors have been shown to influence sepsis care. Knowledge is one of those factors [13], [14], [15]. Nurses need the knowledge to support identifying symptoms of sepsis and its worsening conditions in providing care for patients with severe illnesses in the ICU [16].…”

Section: Introductionmentioning

confidence: 99%

The Knowledge of Nursing Internship Program Students about Early Detection of Sepsis

Stefani

Trisyani

Setyawati

2021

Open Access Maced J Med Sci

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Background: Sepsis is a life-threatening condition due to the failure of the body’s regulation of infection. Knowledge deficit is one of the barriers to early detection and initiation of sepsis care. Nursing internship program students as future nurses need to have sufficient knowledge about early detection of sepsis to support their behavior. Thus, the purpose of this study was to describe the knowledge of nursing internship program students regarding the early detection of sepsis and the demographic factor related to the knowledge. Methods: The study design was a quantitative study. Through the proportionate stratified non-random sampling technique, the researcher involved 143 nursing internship program students of Universitas Padjadjaran. Data collection used a questionnaire based on the Sepsis-3 guidelines to measure nursing internship program students’ knowledge about early detection of sepsis. The data was carried out in July-August 2021. Results: The average knowledge score of the respondents was 70.4 (SD=11.9). More than half of the respondents (56.6%) got a score below the average. Almost all respondents do not know the current definition of sepsis and still use the SIRS definition as clinical criteria for sepsis. However, respondents could identify clinical criteria for sepsis based on qSOFA and analyse sepsis indicators based on case scenarios. Meanwhile, based on its characteristics, the information is a factor that significantly affects the knowledge score (p < 0.05). Conclusion: In conclusion, there is still a gap in the knowledge of the nursing internship program students regarding the update of the Sepsis-3 guidelines. Besides, information is identified as the factor that influences knowledge. Therefore, it suggested that the institution provide further effective educational methods to update students’ knowledge about the early detection of sepsis.

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Barriers to implementing the Sepsis Six guidelines in an acute hospital setting

Abstract: Knowledge deficits, lack of resources and practical issues were barriers identified in this survey. This will inform the educational and process needs of both doctors and nurses in order to improve sepsis care.

Cited by 17 publications

References 10 publications

Sepsis knowledge, skills and attitudes among ward-based nurses

Sepsis knowledge, skills and attitudes among ward-based nurses

Implementation of the 1-Hour Sepsis Bundle and Evaluation of Staff Adherence: An Evidence-based Practice Quality Improvement Project

The Knowledge of Nursing Internship Program Students about Early Detection of Sepsis

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