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

Stefani Stefani; Yanny Trisyani; Anita Setyawati

doi:10.3889/oamjms.2021.7602

Authors

Stefani Stefani Bachelor Study Program, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia; https://orcid.org/0000-0003-1672-0929
Yanny Trisyani Department of Critical Care and Emergency Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia
Anita Setyawati Department of Critical Care and Emergency Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2021.7602

Keywords:

Early detection, Knowledge, Nursing internship program students, Sepsis

Abstract

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.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Republik Indonesia. Decree of the Minister of Health of the Republic of Indonesia Number HK.01.07/MENKES/342/2017 About National Guidelines for Medical Services for the Management of Sepsis. Jakarta: Kementerian Kesehatan; 2017.

Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving sepsis Campaign : International guidelines for management of sepsis and septic shock : 2016. Crit Care Med. 2017;45(3):486-552. https://doi.org/10.1097/ccm.0000000000000192 PMid:28101605 DOI: https://doi.org/10.1097/CCM.0000000000000192

Hunt A. Sepsis : An overview of the signs, symptoms, diagnosis, treatment and pathophysiology. Emerg Nurse. 2019;27(5):32-41. https://doi.org/10.7748/en.2019.e1926 PMid:31475503 DOI: https://doi.org/10.7748/en.2019.e1926

Cohen J, Vincent JL, Adhikari NK, Machado FR, Angus DC, Calandra T, et al. Sepsis : A roadmap for future research. Lancet Infect Dis. 2015;15(5):581-614. PMid:25932591 DOI: https://doi.org/10.1016/S1473-3099(15)70112-X

Proffitt RD, Hooper G. Evaluation of the (qSOFA) tool in the emergency department setting: Nurse perception and the impact on patient care. Adv Emerg Nurs J. 2020;42(1):54-62. https://doi.org/10.1097/tme.0000000000000281 PMid:32000191 DOI: https://doi.org/10.1097/TME.0000000000000281

Christ M. How to manage sepsis in the emergency department leading to a decreased mortality in ICU-the critical care cascade. Acute Care Test. 2011. Available from: https://acutecaretesting.org/en/articles/how-to-manage-sepsis-in-the-emergency-department-leading-to-a-decreased-mortality-in-icu.

Heather A, Bruce R, Maiden J, Fedullo PF, Kim SC. Impact of nurse-initiated sepsis protocol on compliance with sepsis bundles, time ti initial antibiotic, administration, and in-hospital mortality. J Emerg Nurs. 2015;41(2):130-7. https://doi.org/10.1016/j.jen.2014.12.007 PMid:25612516 DOI: https://doi.org/10.1016/j.jen.2014.12.007

Schorr C. Surviving sepsis campaign: Hour-1 bundle. Am Nurse Today. 2018;13(9):16-9.

Harley A, Johnston AN, Denny KJ, Keijzers G, Crilly J, Massey D. Emergency nurses’ knowledge and understanding of their role in recognising and responding to patients with sepsis : A qualitative study. Int Emerg Nurs. 2019;43:106-12. https://doi. org/10.1016/j.ienj.2019.01.005 PMid:30733005 DOI: https://doi.org/10.1016/j.ienj.2019.01.005

Kim HI, Park S. Sepsis: Early recognition and optimized treatment. Tuberc Respir Dis (Seoul). 2019;82(1):6-14. https://doi.org/10.4046/trd.2018.0041 PMid:30302954 DOI: https://doi.org/10.4046/trd.2018.0041

Ahn S, Song J, Moon S, Cho H, Kim JY, Park J. Association between compliance with Surviving Sepsis Campaign guidelines and outcomes among sepsis and septic shock patient in accordance with Sepsis-3 definitions. J Korean Soc Emerg Med.2020;31(1):45-51. https://doi.org/10.3390/jcm8111800 DOI: https://doi.org/10.3390/jcm8111800

Sungkar Y, Considine J, Hutchinson A. Implementation of guidelines for sepsis management in emergency departments: A systematic review. Australas Emerg Care. 2018;21(4):111-20. https://doi.org/10.1016/j.auec.2018.10.003 PMid:30998886 DOI: https://doi.org/10.1016/j.auec.2018.10.003

Cowan SL, Holland JA, Frost I, Kane AD. Recognition and management of sepsis by junior doctors. Futur Hosp J. 2016;3(2):99-102. https://doi.org/10.7861/futurehosp.3-2-99 PMid:31098196 DOI: https://doi.org/10.7861/futurehosp.3-2-99

Breen SJ, Rees S. Barriers to implementing the sepsis six guidelines in an acute hospital setting. Br J Nurs. 2018;27(9):473-8. https://doi.org/10.12968/bjon.2018.27.9.473 PMid:29749778 DOI: https://doi.org/10.12968/bjon.2018.27.9.473

Burney M, Underwood J, McEvoy S, Nelson G, Dzierba A, Kauari V, et al. Early detection and treatment of severe sepsis in the emergency department: Identifying barriers to implementation of a protocol-based approach. J Emerg Nurs. 2012;38(6):512-7. https://doi.org/10.1016/j.jen.2011.08.011 PMid:22079648 DOI: https://doi.org/10.1016/j.jen.2011.08.011

Melquiades J, Campos DA, de Araújo Marques LB, de Oliveira Couras Ramalho CR, da Nóbrega MM. Conception of nurses who work in a general intensive care unit regarding sepsis. Cogitare Enferm. 2015;20(4):706-11.

Nofiyanto M, Munif M, Darussalam M. Pengetahuan dan sikap perawat tentang mobilisasi dini pasien di ICU rsud panembahan senopati bantul Yogyakarta. Media Ilmu Kesehat. 2019;6(1):9-17. https://doi.org/10.30989/mik.v6i1.173 DOI: https://doi.org/10.30989/mik.v6i1.173

Park J, Hwang SY, Shin TG, Jo IJ, Yoon H, Lee TR, et al. Emergency medical service personnel need to improve knowledge and attitude regarding prehospital sepsis care. Clin Exp Emerg Med. 2017;4(1):48-55. https://doi.org/10.15441/ceem.16.159 PMid:28435902 DOI: https://doi.org/10.15441/ceem.16.159

Kleinpell R. Promoting early identification of sepsis in hospitalized patients with nurse-led protocols. Crit Care. 2017;21(1):10-2. https://doi.org/10.1186/s13054-016-1590-0 PMid:28073375 DOI: https://doi.org/10.1186/s13054-016-1590-0

Seymour CW, Carlbom D, Engelberg RA, Larsen J, Bulger EM, Copass MK, et al. Understanding of sepsis among emergency medical services: A survey study. J Emerg Med. 2012;42(6):666-77. DOI: https://doi.org/10.1016/j.jemermed.2011.06.013

Kliger J, Singer SJ, Hoffman FH. Using the integrated nurse leadership program to reduce sepsis mortality. Joint Comm J Qual Patient Saf. 2015;41(6):264-72. https://doi.org/10.1016/s1553-7250(15)41036-0 PMid:25990892 DOI: https://doi.org/10.1016/S1553-7250(15)41036-0

Mcveigh SE. Sepsis menegement in the emergency department. Nurs Clin North Am. 2019;55(1):71-9. PMid:32005367 DOI: https://doi.org/10.1016/j.cnur.2019.10.009

Drahnak DM, Hravnak M, Ren D, Haines AJ, Tuite P. Scripting nurse communication to improve sepsis care. Medsurg Nurs. 2015;25:233-9.

McCaffery M, Onikoyi O, Rodrigopulle D, Syed A, Jones S, Mansfield L, et al. Sepsis-review of screening for sepsis by nursing, nurse driven sepsis protocols and development of sepsis hospital policy/protocols. Nurs Palliat Care. 2016;1:33-7. https://doi.org/10.15761/npc.1000109 DOI: https://doi.org/10.15761/NPC.1000109

Putri HE, Wahyudy MA, Yuliyanto A, Nuraeni F. Development of instruments to measure mathematical anxiety of elementary school students. Int J Learn Teach Educ Res. 2020;19(6):282-302. https://doi.org/10.26803/ijlter.19.6.17 DOI: https://doi.org/10.26803/ijlter.19.6.17

Polit DF, Beck VT. Nursing Research: Generating and Assessing Evidence for Nursing Practice. China: Wolters Kluwer; 2017.

Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA. 2016;315(8):801-10. PMid:26903338 DOI: https://doi.org/10.1001/jama.2016.0287

Tilton KE. Sepsis Knowledge in Undergraduate Nursing Students, Undergrad Theses. China: Honor; 2019.

Schmedding M, Adegbite BR, Gould S, Beyeme JO, Adegnika AA, Grobusch MP, et al. A prospective comparison of quick sequential organ failure assessment, systemic inflammatory response syndrome criteria, universal vital assessment, and modified early warning score to predict mortality in patients with suspected infection in Gabon. Am Soc Trop Med Hyg. 2019;100(1):202-8. https://doi.org/10.4269/ajtmh.18-0577 PMid:30479248 DOI: https://doi.org/10.4269/ajtmh.18-0577

Spoto S, Nobile E, Carnà EP, Fogolari M, Caputo D, De Florio L, et al. Best diagnostic accuracy of sepsis combining SIRS criteria or qSOFA score with procalcitonin and mid-regional pro-adrenomedullin outside ICU. Sci Rep. 2020;10(1):1-11. https://doi.org/10.1038/s41598-020-73676-y DOI: https://doi.org/10.1038/s41598-020-73676-y

Horeczko T, Green JP, Panacek EA. Epidemiology of the systemic inflammatory response syndrome (SIRS) in the emergency department. West J Emerg Med. 2014;15(3):329-36. https://doi.org/10.5811/westjem.2013.9.18064 PMid:24868313 DOI: https://doi.org/10.5811/westjem.2013.9.18064

Rowe A, McClelland A, Billingham K. Community Health Needs Assessment: An Introductory Guide for the Family Health Nurse in Europe. Geneva: World Health Organization; 2001.

Adegbite BR, Edoa JR, Rylance J, Jacob ST, Kawal P, Adegnika AA, et al. Knowledge of health workers relating to sepsis awareness and management in Lambaréné, Gabon. Acta Trop. 2021;219:1-7. DOI: https://doi.org/10.1016/j.actatropica.2021.105914

López-Izquierdo R, Del Brio-Ibañez P, Martín-Rodríguez F, Mohedano-Moriano A, Polonio-López B, Maestre-Miquel C, et al. Role of qSOFA and SOFA scoring systems for predicting in-hospital risk of deterioration in the emergency department. Int J Environ Res Public Health. 2020;17(22):8367. https://doi.org/10.3390/ijerph17228367 PMid:33198151 DOI: https://doi.org/10.3390/ijerph17228367

Wiewel MA, Harmon MB, van Vught LA, Scicluna BP, Hoogendijk AJ, Horn J, et al. Risk factors, host response and outcome of hypothermic sepsis. Crit Care. 2016;20(1):1-9. PMid:27737683 DOI: https://doi.org/10.1186/s13054-016-1510-3

Budiman B, Riyanto A. Capita Selecta Knowledge and Attitude Questionnaire in Health Research. Jakarta: Salemba Medika; 2013.

Harley A, Massey D, Ullman AJ, Reid-Searl K, Schlapbach LJ, Takashima M, et al. Final year nursing student’s exposure to education and knowledge about sepsis: A multi-university study. Nurse Educ Today. 2021;97:104703. https://doi.org/10.1016/j.nedt.2020.104703 DOI: https://doi.org/10.1016/j.nedt.2020.104703

Delaney MM, Friedman MI, Dolansky MA, Fitzpatrick JJ. Impact of a sepsis educational program on nurse competence. J Contin Educ Nurs. 2015;46(4):179-86. https://doi.org/10.3928/00220124-20150320-03 DOI: https://doi.org/10.3928/00220124-20150320-03

Storozuk SA, Macleod ML, Freeman S, Banner D. Australasian emergency care a survey of sepsis knowledge among Canadian emergency department registered nurses. Australas Emerg Care. 2019;22(2):119-25. https://doi.org/10.1016/j.auec.2019.01.007 PMid:31042531 DOI: https://doi.org/10.1016/j.auec.2019.01.007

Nucera G, Esposito A, Tagliani N, Jane Baticos C, Marino P. Physicians’ and nurses’ knowledge and attitudes in management of sepsis: An Italian study. J Health Soc Sci. 2018;3(1):13-26.

Kim B, Jeong Y. Effects of a case-based sepsis education program for general ward nurses on knowledge, accuracy of sepsis assessment, and self-efficacy. J Korean Biol Nurs Sci. 2017;22(4):260-70. https://doi.org/10.7586/jkbns.2020.22.4.260 DOI: https://doi.org/10.7586/jkbns.2020.22.4.260

Jones AD. The impact of integrating quality and safety education for nurses’ safety competency in first-year associate degree nursing students. Teach Learn Nurs. 2013;8(4):140-6. https://doi.org/10.1016/j.teln.2013.06.001 DOI: https://doi.org/10.1016/j.teln.2013.06.001

Davis A, Henderson J, Langmack G. Development of an e-learning package for sepsis care. Br J Nurs. 2016;25(6):292-6. PMid:27019164 DOI: https://doi.org/10.12968/bjon.2016.25.6.292

Windle RJ, McCormick D, Dandrea J, Wharrad H. The characteristics of reusable learning objects that enhance learning: A case-study in health-science education. Br J Educ Technol. 2011;42(5):811-23. https://doi.org/10.1111/j.1467-8535.2010.01108.x DOI: https://doi.org/10.1111/j.1467-8535.2010.01108.x

Evans KH, Daines W, Tsui J, Strehlow M, Maggio P, Shieh L. Septris: A novel, mobile, online, simulation game that improves sepsis recognition and management. Acad Med. 2015;90(2):180-4. https://doi.org/10.1097/acm.0000000000000611 PMid:25517703 DOI: https://doi.org/10.1097/ACM.0000000000000611