Improving the recognition and treatment of sepsis in hospital

Early recognition and treatment of sepsis, a life threatening reaction to infection, can save lives.

Bangor University reports new research by Eirian Edwards and Lorelei Jones, from its School of Medical and Health Sciences, looked at sepsis knowledge, skills and attitudes of ward nurses and whether sepsis training for ward nurses can improve care.

While there are previous studies from A&E and ICU, this was one of the first studies to investigate the recognition and treatment of sepsis in patients on general medical and surgical wards, and to assess the effects of training.

A questionnaire was completed by ninety eight nurses from sixteen wards (39% of nurses on the wards) across an acute teaching hospital in Wales. The study found that nurses who had received sepsis training were significantly more likely to know the screening criteria for sepsis, to have a positive attitude to screening and management of sepsis, were more confident in screening for sepsis and more likely to have screened a patient for sepsis.

The most frequently reported barrier to timely recognition and treatment of sepsis on the wards was workload and inadequate staffing. Some nurses expressed concerns about inexperienced or unfamiliar staff on the wards, such as healthcare assistants and agency staff, when abnormal observations were not escalated appropriately. Sepsis training, sepsis tools (such as screening criteria, sepsis bundle and patient group directive) and peer support were all reported to help timely recognition and treatment of sepsis. The authors recommend sepsis training for all nurses.

Study co-author Dr Lorelei Jones, Lecturer in Healthcare Organisation and Governance in the School of Medical and Health Sciences, said “One of the things that I found interesting was the importance of support from colleagues when using clinical skills. This suggests that when over-use of temporary and agency staff erodes the peer support available to nurses this has knock on effects for the recognition and treatment of patients who are deteriorating. The study also raises questions about access to sepsis training for agency staff. ”

The research is published in the British Journal of Nursing.

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