The Knowledge of Nursing Internship Program Students about Early Detection of Sepsis
Keywords:Early detection, Knowledge, Nursing internship program students, Sepsis
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.
Plum Analytics Artifact Widget Block
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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.
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
Mcveigh SE. Sepsis menegement in the emergency department. Nurs Clin North Am. 2019;55(1):71-9. PMid:32005367
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
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
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
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
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
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
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.
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
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
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
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
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
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
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
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
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
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
How to Cite
Copyright (c) 2021 Stefani Stefani, Yanny Trisyani, Anita Setyawati (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All rights reserved.