Awareness Of Sepsis Research Articles

Factors related to sepsis in critical care setting in Rwanda selected referral hospital

BACKGROUND Sepsis is described as potentially fatal organ failure induced by an unbalanced host response to infection. Annual estimates put the number of sepsis cases at over 19 million. The number of sepsis-related deaths is estimated to reach 5 million, with the vast majority happening in LMICs. However, such information is required to increase awareness of sepsis's global impact, especially in developing countries like Rwanda. The study aimed to evaluate the factors related to sepsis in a critical care setting in Rwanda's selected referral hospital. METHODOLOGY A cross-sectional study design with a quantitative approach was conducted and simple random sampling was used. Files of 191 study participants and a structured questionnaire were used in data collection, bivariate and multivariate logistic regression in SPSS version 21 was used in data analysis, and results were presented in tables. RESULTS The prevalence of sepsis was 40.3%. By plotting bivariate analysis the results showed that sepsis was significantly associated with the following variables; self-employed as an occupation with (OR=0.216, 95%CI:0.047-0.987) p 0.48 taking reference for unemployed; pneumonia with sepsis at (OR=1.993, 95%CI:0.657-6.043) p 0.023, systemic infection (OR=0.329, 95%CI:0.104-1.044) p 0.059; other procedure with (OR=4.735,95%CI:1.509- 14.855); procedure timeframe not mentioned with (OR=0.123,95%CI:0.027-0.553) p 0.032; hospitalized 15 days and more with OR=6.697 (95%CI:0.809-59.863) and p 0.032. CONCLUSION The prevalence of sepsis was 40.3% and factors related to sepsis include; occupation, having pneumonia, systemic infection, timeframe for carrying out the procedure, and patient being hospitalized for 15 days and more.

KAP ANALYSIS AND DECISION-MAKING OF NURSES REGARDING SEPSIS ASSESSMENT AND MANAGEMENT IN CRITICALLY ILL PATIENTS

Sepsis is a life-threatening condition that requires prompt identification and management, particularly in critically ill patients. Nurses play a pivotal role in sepsis management, and their knowledge, attitudes, and practices directly impact patient outcomes. However, there is limited data on the awareness and competency of nurses regarding sepsis assessment and management, especially in low-resource settings. Objective: This study aimed to evaluate the knowledge, attitudes, and practices (KAP) of nurses towards the assessment and management of sepsis in critically ill patients. Methods: A cross-sectional study was conducted in the Intensive Care Unit (ICU) and emergency department of DHQ Hospital, Narowal, from July 2023 to July 2024. A total of 100 ICU and CCU nurses were selected using convenience sampling. Data were collected through a 32-item questionnaire that assessed knowledge, attitudes, and practices related to sepsis. Additionally, the 24-item Nursing Decision-Making Instrument (NDMI) was used to evaluate decision-making skills. Descriptive statistics were calculated, and relationships between variables were analyzed using t-tests and ANOVA. Results: The mean knowledge score was 5.1 ± 1.8, with 83% of nurses demonstrating poor awareness of sepsis. The mean attitude score was 2.0 ± 0.9, with 85% of nurses displaying negative attitudes toward sepsis management. The mean practice score was 79 ± 17.8, with 72% of nurses showing poor practice skills. The mean decision-making score on the NDMI was 63.3 ± 19.6. Qualifications (p=0.010, p=0.00) and work experience (p=0.005, p=0.050) significantly influenced knowledge and practice scores. Moreover, knowledge and practice scores varied significantly with different modes of decision-making (p<0.001, p=0.020). Conclusion: The study revealed that ICU and emergency department nurses had insufficient knowledge, negative attitudes, and inadequate practices concerning sepsis assessment and management. Training programs, targeted educational interventions, and policy reforms are urgently required to improve nurses' competency and decision-making skills in sepsis management, ultimately enhancing patient outcomes.

Quality Initiative to Improve Emergency Department Sepsis Bundle Compliance Through Resident Education and Awareness

Introduction: Timely recognition of sepsis is important for physicians as each hour of delay before sepsis is treated is associated with a 4-9% increase in mortality. In order to monitor the care provided in critically ill patients, the Centers for Medicare & Medicaid Services (CzMS) designed Hospital Quality Initiatives which include The Severe Sepsis and Septic Shock Management Bundle (SEP-1). A prior study conducted by Alexander et al at McLaren Oakland Hospital’s Emergency Department (ED) demonstrated improvement in bundle compliance with standardization in documentation and order entry in EMR in the form of Sepsis Macros. Subsequently, the compliance rates with the SEP-1 bundle at McLaren Oakland were found to have fluctuated monthly. This fluctuation affects both patient outcomes and reimbursement for the care provided. Therefore, we hypothesized further education needed to be provided to ensure quality care of septic patients. Objectives: Our project aimed to improve sepsis bundle compliance at McLaren Oakland by providing education to the PGY-1 class and off-service residents on how to accurately utilize the pre-populated sepsis macro and order sets in EMR in order to recognize and treat sepsis in a timely manner. Methods: We developed a Sepsis Education sheet sent in the form of a monthly educational email. This initiative targeted PGY-1s, instructing them on how to appropriately use the new sepsis macro to have timely recognition of sepsis and appropriate orders placed to meet compliance guidelines. Our monthly educational email was sent from August 2022 to February 2023. Results: Sepsis Compliance data was analyzed from August 2022 to February 2023 and compared to August 2021 to February 2022. After implementation of the Sepsis Education sheet, the mean of compliance rates actually decreased from 64% (SD= 0.101 95% CI: 0.575 to 0.719) to 47% (SD= 0.116 95% CI: 0.388 to 0.560) during intervention (p-value = 0.0101). Conclusion: Our intervention was not successful in increasing compliance with SEP-1 bundle requirements. We therefore determined that PGY-1 awareness of sepsis and use of macros is not the limiting factor in sepsis compliance for McLaren Oakland Hospital’s ED. Further investigation regarding limiting factors in sepsis bundle compliance at our institution will need to be conducted.

Recognition and Awareness of Sepsis by First-Aid Providers in Adults With Suspected Infection: A Scoping Review.

Sepsis accounts for a significant proportion of preventable deaths worldwide and early treatment has been found to be a mainstay of decreasing mortality. Early identification of sepsis in the first-aid setting is critical as this results in a shorter time to hospital presentation and management with antibiotics and initial resuscitation. Our aim was to explore the existing literature related to either sepsis recognition or awareness of sepsis by first-aid providers who are evaluating an adult suspected of an acute infection. Our scoping review was performed as part of the International Liaison Committee on Resuscitation's (ILCOR) continuous evidence evaluation process to update the 2024 ILCOR Consensus on Science with Treatment Recommendations. We searched Embase, Medline, and Cochrane databases from their inception to January 17, 2023, with updated searches performed on November 21, 2023, and December 2, 2023. The gray literature search was conducted on August 29, 2023.The population included adults presenting with an acute illness exhibiting signs and symptoms of a severe infection.Outcomes included sepsis recognition or awareness of sepsis by a lay first-aid provider. After reviewing 4380 potential sources, four reviews (three systematic reviews and one scoping review), 11 observational studies, and 27 websites met the inclusion criteria. No study directly addressed our PICOST (Population, Intervention, Comparator, Outcomes, Study Design, and Timeframe) question as none were performed in the first-aid setting. Three systematic reviews and nine observational studies that assessed the ability of early warning scores to detect sepsis and predict adverse outcomes secondary to sepsis had inconsistent results, but many found the screening tools to be useful. One scoping review and one observational study found public knowledge and awareness of sepsis to be variable and dependent upon healthcare employment, location, education level, ethnicity, sex, and age. Signs and symptoms associated with sepsis as listed by gray literature sources fell primarily under nine general categories as a means of educating the public on sepsis recognition. Although this scoping review did not identify any studies that directly addressed our outcomes, it highlights the need for future research to better understand the recognition of sepsis in first-aid settings.

Awareness and Perception of Sepsis Among the Urban and Rural Population in India

Traditionally, immunity has been defined as a defence against, or as a resistance to, contagious and infectious diseases. However, in modern understanding, it has become apparent that the immune system's mechanisms that protect against disease can also react against harmless substances. In some instances of severe infection, it's important to be aware that the immune response generated may have unintended adverse consequences. These conditions are associated with sepsis and may even turn out to be life-threatening in certain cases. Sepsis is a whole spectrum of diseases with a systemic and dysregulated host response to an infection. Therefore, it is of utmost importance to investigate and understand the level of awareness among the general public regarding this condition. This study aimed to understand the level of awareness about sepsis among the general population and to compare the perspectives of urban and rural populations. This study revealed that the awareness among both populations is low. Efforts should be made to increase awareness in India.

Sepsis incidence, suspicion, prediction and mortality in emergency medical services: a cohort study related to the current international sepsis guideline

PurposeSepsis suspicion by Emergency Medical Services (EMS) is associated with improved patient outcomes. This study assessed sepsis incidence and recognition by EMS and analyzed which of the screening tools recommended by the Surviving Sepsis Campaign best facilitates sepsis prediction.MethodsRetrospective cohort study of claims data from health insurances (n = 221,429 EMS cases), and paramedics’ and emergency physicians’ EMS documentation (n = 110,419); analyzed outcomes were: sepsis incidence and case fatality compared to stroke and myocardial infarction, the extent of documentation for screening-relevant variables and sepsis suspicion, tools’ intersections for screening positive in identical EMS cases and their predictive ability for an inpatient sepsis diagnosis.ResultsIncidence of sepsis (1.6%) was similar to myocardial infarction (2.6%) and stroke (2.7%); however, 30-day case fatality rate was almost threefold higher (31.7% vs. 13.4%; 11.8%). Complete vital sign documentation was achieved in 8.2% of all cases. Paramedics never, emergency physicians rarely (0.1%) documented a sepsis suspicion, respectively septic shock. NEWS2 had the highest sensitivity (73.1%; Specificity:81.6%) compared to qSOFA (23.1%; Sp:96.6%), SIRS (28.2%; Sp:94.3%) and MEWS (48.7%; Sp:88.1%). Depending on the tool, 3.7% to 19.4% of all cases screened positive; only 0.8% in all tools simultaneously.ConclusionIncidence and mortality underline the need for better sepsis awareness, documentation of vital signs and use of screening tools. Guidelines may omit MEWS and SIRS as recommendations for prehospital providers since they were inferior in all accuracy measures. Though no tool performed ideally, NEWS2 qualifies as the best tool to predict the highest proportion of septic patients and to rule out cases that are likely non-septic.

Review and prospects of international clinical research in critical care medicine in 2023

The main clinical research advances of critical care in 2023 includes: new trials of Chinese herbal medicine, hydroxocobalamin (vitamin B12), methylene blue as well glucocorticoids have shown the potential to improve outcomes of patients with sepsis and septic shock; international committees launched new global definition and managing recommendations for acute respiratory distress syndrome (ARDS). Besides, a cluster of new evidences has emerged in many aspects as following: fluid control strategy in sepsis (restrictive/liberative), antibiotic infusion strategy (continuous/intermittent), oxygen-saturation targets for mechanical ventilation (conservative/liberative), blood pressure targets after resuscitation from out-of-hospital cardiac arrest (hypotension/hypertension), blood pressure targets after successful stroke thrombectomy (intensive/conventional), and nutritional support strategies (low protein-calories/conventional protein-calories, fasting/persistent feeding before extubation). Thus, given above progress, carrying out high -quality domestic multi-center clinical registration researches, constructing shareable standardized databases, as well raising public awareness of sepsis, should be the essential steps to improve our level of intensive care medicine.

Sepsis Canada: Building a national research network for sepsis awareness

Sepsis Canada: Building a national research network for sepsis awareness Sepsis is a life-threatening condition estimated to affect 49 million people annually worldwide; yet it is not widely understood. In this article, we hear how Sepsis Canada is working to promote sepsis awareness through supporting research, public education, and cross-disciplinary training. In 2017 the World Health Assembly declared sepsis, defined as the life-threatening organ dysfunction due to infection, a global health priority. They emphasized the critical need for advancements in prevention, diagnosis, and clinical management. With a staggering cost exceeding $2.6 billion annually and a mortality rate ranging from 20-35% for those requiring ICU care, the impact of sepsis on the Canadian healthcare system has been immense. (1)

Evaluating the impact of training on therapeutic radiographer awareness of the signs and symptoms of neutropenic sepsis in patients undergoing concurrent chemoradiotherapy

IntroductionNeutropenic sepsis is a life-threatening combination of neutropenia and infection. Patients undergoing concurrent chemoradiotherapy are at a high risk of neutropenic sepsis and thus are likely to present in a clinical setting. This study aimed to evaluate levels of Therapeutic Radiographers' understanding of sepsis signs and response pathways along with the impact of a training session on this. MethodsA teaching session at the trust was conducted by the Sepsis Lead Nurse and utilised a range of active learning techniques including scenario-based questions and a sepsis game. Pre and post-training questionnaires were completed by participants which comprised of multiple-choice questions related to sepsis identification and response. Respondents were asked to rate their confidence in each answer. This enabled scoring to award penalties for higher levels of confidence in incorrect answers and reward high confidence in correct answers. Lower levels of confidence attracted or lost smaller marks. ResultsThere was a statistically significant (p < 0.0002) improvement in questionnaire scores after the training session from 42% to 66%. Lower scores on the pre-test responses mainly related to incorrect selection of responses to scenario questions. ConclusionThis service evaluation has highlighted a lack of sepsis awareness amongst Therapeutic Radiographers. It also demonstrates that an active learning based training session can significantly improve understanding of sepsis. Implications for practiceSepsis training utilising scenario and response questions should be provided to Therapeutic Radiographers more frequently who are likely to work with patients undergoing concurrent chemoradiotherapy.

Sepsis epidemiology in Australian and New Zealand children (SENTINEL): protocol for a multicountry prospective observational study

IntroductionSepsis affects 25.2 million children per year globally and causes 3.4 million deaths, with an annual cost of hospitalisation in the USA of US$7.3 billion. Despite being common, severe and...

Nurses' and Physicians' Experiences After Implementation of a Quality Improvement Project to Improve Sepsis Awareness in Hospitals.

Previous research has explored nurses´ experience with the implementation of early detection alert systems, and nurses and physicians' perceptions of sepsis management and use of sepsis triage. As one of the first, this study aims to investigate the perceived usefulness of an interdisciplinary quality improvement project including standardized sepsis patient pathway to improve the early identification and treatment of sepsis patients. This study was a qualitative study that employed semi-structured interviews with thirteen ward nurses and five ward physicians recruited by convenience and respondent-driven sampling, respectively. The interviews explored the perceived usefulness of mutual training in sepsis care in medical hospital wards. We applied Systematic Text Condensation to analyze the experiences and knowledge of professional identification and cooperation in early identification of sepsis patients. The results revealed three main themes: Awareness of sepsis, collaboration between nurses and physicians, and clinical assessment and judgement. The findings highlighted the positive impact of the project in terms of raising awareness, improving communication, and enhancing the ability to detect and treat sepsis. The study also identified the importance of repetition and reminders to maintain awareness, the need for ongoing training for new healthcare professionals, and the challenges of collaboration and decision-making processes. The sepsis intervention seemed successful in improving awareness of sepsis and enhancing interprofessional collaboration between nurses and physicians. Health professionals continued to rely on their clinical judgment but increased the use of objective measurements and communication of vital signs. Continuous repetition and education for new colleagues were identified as important factors for the sustainability of the intervention. Overall, the study highlights the importance of standardized protocols and training for early detection and management of sepsis in healthcare settings.

High pretreatment disease burden as a risk factor for infectious complications following CD19 chimeric antigen receptor T-cell therapy for large B-cell lymphoma.

Infection has emerged as the chief cause of non-relapse mortality (NRM) post CD19-targeting chimeric antigen receptor T-cell therapy (CAR-T) therapy. Even though up to 50% of patients may remain infection-free, many suffer multiple severe, life-threatening, or fatal infectious events. The primary aim of this study was to explore severe and life-threatening infections post licensed CAR-T therapy in large B-cell lymphoma, with a focus on the role of disease burden and disease sites in assessing individual risk. We sought to understand the cohort of patients who experience ≥2 infections and those at the highest risk of infectious NRM. Our analysis identifies a higher disease burden after bridging therapy as associated with infection events. Those developing ≥2 infections emerged as a uniquely high-risk cohort, particularly if the second (or beyond) infection occurred during an episode of immune effector cell-associated neurotoxicity syndrome (ICANS) or while on steroids and/or anakinra for ICANS. Herein, we also describe the first reported cases of "CAR-T cold sepsis," a phenomenon characterized by the lack of an appreciable systemic inflammatory response at the time of detection of infection. We propose a risk-based strategy to encourage heightened clinician awareness of cold sepsis, with a view to reducing NRM.

Trend in public awareness of sepsis in Australia between 2016 and 2022: An analysis of three national surveys’ data

Trend in public awareness of sepsis in Australia between 2016 and 2022: An analysis of three national surveys’ data

Sepsis awareness and trajectory: Never forget and never stop fighting

In this editorial, guest editor Michael A. Tijerina, MSN, RN-BC, NPD-BC, shares a personal story highlighting sepsis awareness and the trajectory of the disease. He also calls for healthcare practitioners never to forget and never stop fighting the war on sepsis. This includes the importance of prevention, early recognition, and treatment.

Public Awareness and Knowledge of Sepsis: A Cross-Sectional Survey of Adults in the Western Region of Saudi Arabia.

Sepsis is a condition in which the body responds improperly to harmful microorganisms and infections, which triggers a chain reaction throughout the body. It is a life-threatening medical emergency. Infections that lead to sepsis, in most cases, start in the lungs, urinary tract, skin, or gastrointestinal tract. Without timely treatment, sepsis rapidly leads to multi-organ failure and death. The risk factors for sepsis include a weakened immune system, being 65 years of age or older, and chronic medical conditions including diabetes, lung disease, and kidney disease. A thorough understanding of the warning signs and symptoms, as well as prompt medical attention, are required for successful sepsis management. Early detection, antimicrobial therapy, and intensive supportive care are the cornerstones of the best sepsis management. This study aimed to assess the public awareness and knowledge of sepsis in the Western region of Saudi Arabia. This was a cross-sectional study conducted from the beginning of June till the end of August 2023, among 425 Saudi adults in the Western region above the age of 18 years. Data collection was carried out by administering a questionnaire through an online platform. The questionnaire included demographic information, risk factors, symptoms, protective factors, and the source of information about sepsis. The data collected were reviewed, coded, and then fed into IBM SPSS Statistics software for Windows, Version 21 (released 2012; IBM Corp., Armonk, NY). The study found that almost half (47.8%) of participants were aware of bacterial septicemia, with the most common sources of awareness being the internet (48.3%) and healthcare professionals (47.8%). Low immunity (75.9%) and infection (39.4%) have been the most frequently reported risk factors. Fever (31.5%) was the most commonly reported symptom. Participants from Yanbu and Jeddah and those in the healthcare sector had significantly higher awareness levels. The majority of participants (93.1%) had poor knowledge about the risk factors and symptoms of septicemia, with only 3.4% having fair or good knowledge. Sociodemographic characteristics did not significantly affect knowledge about septicemia (P>0.05). In summary, this study reveals that while awareness of bacterial septicemia is relatively high among the sample population, knowledge about the risk factors and symptoms of the condition is low. The internet, healthcare professionals, and social media play significant roles in raising awareness about bacterial septicemia. Participants from Yanbu and Jeddah, students, and healthcare sector workers had higher awareness levels compared to other groups. However, overall knowledge levels regarding bacterial septicemia were poor across various demographic characteristics. This highlights the need for targeted educational interventions to improve knowledge and understanding of septicemia and its risk factors and symptoms among the general population. Further research is needed to identify the reasons for low knowledge levels and develop effective strategies to improve awareness about bacterial septicemia.

Sepsis awareness month: a reminder of the need for swift action

Sepsis awareness month: a reminder of the need for swift action

The effects of sociodemographic factors and comorbidities on sepsis: A nationwide Swedish cohort study

Sepsis is a severe condition, representing a significant public health concern, especially in the elderly. There is, however, little insight into the potential effects of sociodemographic factors and comorbidities on sepsis incidence and how these factors interact. This was a nationwide open cohort study including individuals (N = 6746010) in Sweden ≥ 18 years of age spanning from 1997 to 2018, with 116175995 person years of follow-up. The outcome was time to first occurrence of sepsis. The following variables were included in the analysis: sociodemographic factors (age, sex, income, education, marital status, region of residency, and country of origin), severe mental disorders (schizophrenia and bipolar disorders), and Charlson Comorbidity Index. Interaction tests were conducted. A total of 161558 individuals were diagnosed with sepsis during the study period, corresponding to an incidence rate of 13.9 per 10000 person years (95% CI: 13.8 – 14.0). The main findings were that male sex, high age, low education, and comorbid conditions were positively associated with sepsis, after adjustments for the other covariates. Being aged 80 years and above yielded a HR of 18.19 (95% CI: 17.84 – 18.55) and the effect of high age was more than twice as high in men than in women. In conclusion, this large nationwide cohort found that several sociodemographic factors and comorbid conditions were independently associated with sepsis and men were more affected by higher age than women. These findings can help improve sepsis awareness and preventive work in risk groups.

Sepsis awareness and knowledge amongst nurses, physicians and paramedics of a tertiary care center in Switzerland: A survey-based cross-sectional study.

Sepsis is a leading cause of morbidity and mortality. Prompt recognition and management are critical to improve outcomes. We conducted a survey among nurses and physicians of all adult departments of the Lausanne University Hospital (LUH) and paramedics transporting patients to our hospital. Measured outcomes included professionals' demographics (age, profession, seniority, unit of activity), quantification of prior sepsis education, self-evaluation, and knowledge of sepsis epidemiology, definition, recognition, and management. Correlation between surveyed personnel and sepsis perceptions and knowledge were assessed with univariable and multivariable logistic regression models. Between January and October 2020, we contacted 1'216 of the 4'417 professionals (27.5%) of the LUH, of whom 1'116 (91.8%) completed the survey, including 619 of 2'463 (25.1%) nurses, 348 of 1'664 (20.9%) physicians and 149 of 290 (51.4%) paramedics. While 98.5% of the participants were familiar with the word "sepsis" (97.4% of nurses, 100% of physicians and 99.3% of paramedics), only 13% of them (physicians: 28.4%, nurses: 5.9%, paramedics: 6.8%) correctly identified the Sepsis-3 consensus definition. Similarly, only 48% and 49.3% of the physicians and 10.1% an 11.9% of the nurses knew that SOFA was a sepsis defining score and that the qSOFA score was a predictor of increased mortality, respectively. Furthermore, 15.8% of the physicians and 1.0% of the nurses knew the three components of the qSOFA score. For patients with suspected sepsis, 96.1%, 91.6% and 75.8% of physicians respectively chose blood cultures, broad-spectrum antibiotics and fluid resuscitation as therapeutic interventions to be initiated within 1 (76.4%) to 3 (18.2%) hours. For nurses and physicians, recent training correlated with knowledge of SOFA score (ORs [95%CI]: 3.956 [2.018-7.752] and 2.617 [1.527-4.485]) and qSOFA (ORs [95%CI]: 5.804 [2.653-9.742] and 2.291 [1.342-3.910]) scores purposes. Furthermore, recent training also correlated with adequate sepsis definition (ORs [95%CI]: 1.839 [1.026-3.295]) and the components of qSOFA (ORs [95%CI]: 2.388 [1.110-5.136]) in physicians. This sepsis survey conducted among physicians, nurses and paramedics of a tertiary Swiss medical center identified a deficit of sepsis awareness and knowledge reflecting a lack of sepsis-specific continuing education requiring immediate corrective measures.

Sepsis awareness and understanding in Australian parents: A National Child Health Poll survey.

The primary aim of the study was to assess parental awareness and understanding of childhood sepsis. Secondary aims included parental knowledge of the signs and symptoms of sepsis, and what parents would do if they suspected sepsis in their own child. An online questionnaire was administered as part of The Royal Children's Hospital National Child Health Poll. The Poll is a quarterly online survey of a sample of Australian families with at least one child aged 0-17 years old, representative by age, sex and state of residence. The questionnaire collected information on parental sepsis awareness, and for those defined as sepsis aware, information was gathered on sepsis knowledge, signs and symptoms, and how they would respond if they thought their child had sepsis. Signs and symptoms highly likely to be suggestive of sepsis were predefined based on published sepsis guidelines and awareness campaigns. The questionnaire was completed by 3352 parents. Of those, 2065 (61.6%) had heard of the term sepsis and 2818 (84.1%) had heard of at least one alternate term for sepsis and were classified as 'sepsis aware'. Of the 'sepsis aware' parents, 82.9% knew that sepsis was a life-threatening condition, but only 33.8% knew that once diagnosed, sepsis may not be curable. Only 27.8% thought that they could recognise the signs of sepsis in their own child. Less than half of respondents correctly identified signs and symptoms that were highly likely to be suggestive of sepsis. Seventy-one per cent of parents said they would seek urgent care at a hospital emergency department or other facility if they thought their child had sepsis, but only 37.3% said they would consider calling an ambulance. There are considerable knowledge gaps in parental awareness and knowledge of sepsis, particularly sepsis recognition. Parental education should target these knowledge gaps in order to improve healthcare-seeking behaviour and communication between parents and healthcare providers in order to facilitate early sepsis diagnosis and treatment.

Prehospital Recognition and Management of Pediatric Sepsis: A Qualitative Assessment

Background and Purpose Sepsis is a life-threatening disease in children and is a leading cause of morbidity and mortality. Early prehospital recognition and management of children with sepsis may have significant effects on the timely resuscitation of this high-risk clinical condition. However, the care of acutely ill and injured children in the prehospital setting can be challenging. This study aims to understand barriers, facilitators, and attitudes regarding recognition and management of pediatric sepsis in the prehospital setting. Methods This was a qualitative study of EMS professionals participating in focus groups using a grounded theory-based design to gather information on recognition and management of septic children in the prehospital setting. Focus groups were held for EMS administrators and medical directors. Separate focus groups were held for field clinicians. Focus groups were conducted via video conference until saturation of ideas was reached. Using consensus methodology, transcripts were coded in an iterative process. Data were then organized into positive and negative factors based on the validated PRECEDE-PROCEED model for behavioral change. Results Thirty-eight participants in six focus groups identified nine environmental factors, 21 negative factors, and 14 positive factors pertaining to recognition and management of pediatric sepsis. These findings were organized into the PRECEDE-PROCEED planning model. Pediatric sepsis guidelines were identified as positive factors when they did exist and negative factors when they were complicated or did not exist. Six interventions were identified by participants. These include raising awareness of pediatric sepsis, increasing pediatric education, receiving feedback on prehospital encounters, increasing pediatric exposure and skills training, and improving dispatch information. Conclusion This study fills a gap by examining barriers and facilitators to prehospital diagnosis and management of pediatric sepsis. Using the PRECEDE-PROCEED model, nine environmental factors, 21 negative factors, and 14 positive factors were identified. Participants identified six interventions that could create the foundation to improve prehospital pediatric sepsis care. Policy changes were suggested by the research team based on the results of this study. These interventions and policy changes provide a roadmap for improving care in this population and lay the groundwork for future research.