Improving Nurses’ Knowledge on Sepsis Identification and Management at Mulago National Referral Hospital: A Quasi Experimental Study

Abstract

Background

Sepsis is a global pandemic and public health concern. There is a paucity of data relating to its management and outcomes in the developing world. The surviving sepsis campaign (SSC) guidelines have been developed to improve outcomes of patients with sepsis. There are no documented in-hospital protocols on sepsis management for nurses in Uganda. This study evaluated the effect of an educational intervention on nurses’ knowledge of SSC guidelines in management of patients with sepsis at Mulago National Referral Hospital.

Methods

We used a quasi-experimental design and recruited 40 nurses from neuro-surgical ward and ICU. Pre- and post-intervention assessments were conducted using a validated self-administered questionnaire between October 2020 to February 2021. The intervention was conducted through sessions of presentations, watching videos, and case studies. Data were entered in excel, cleaned, and exported to Stata version 16. Median and interquartile range were used for continuous variables while frequencies and percentages were used for categorical variables. Mean knowledge scores were computed for pre- and post-test evaluation. A paired t-test was used to compare the pre- and post-test knowledge scores at p ≤ 0.05 and 95% confidence interval.

Results

In this study, 57.5% of nurses were from ICU, 67.7% were females and 70% diploma holders. Median age was 32 (IQR= 21.5–35.5) years. In the post test all nurses were able to score above the preset acceptable score of 50% on the current sepsis guidelines. Mean knowledge score was 3.6 (SD = 1.8) pretest and 8.4 (SD = 1.2) posttest. There was a significant difference in pre and post-intervention mean knowledge scores of 4.9 (SD = 1.90, 95% CI: 4.2–4.5; t (39) = 16.242, p <0.001).

Conclusion

The educational intervention improved nurses’ knowledge on SSC guidelines. Regular continuous professional nursing education on sepsis could improve nurses’ knowledge and quality of care for patients with sepsis.

Keywords:

• nurses
• sepsis
• knowledge
• surviving sepsis campaign guidelines
• management

Abbreviations

AKI, acute kidney injury; ICU, Intensive Care Unit; iSSC, International Surviving Sepsis Guidelines; MAP, mean arterial pressure; MNRH, Mulago National Referral Hospital; MUST- REC, Mbarara University of Science and Technology; qSOFA, quick sequential organ failure assessment; SIRS, systemic inflammatory response syndrome; SOFA, sequential organ failure assessment; SSC, Surviving Sepsis Guidelines.

Data Sharing Statement

The datasets generated and analyzed during the study are available from the corresponding author on request.

Acknowledgments

We acknowledge first mile program for the financial support in this study. We thank the administration of Mulago National referral hospital and participants who participated in this study.

Author Contributions

All authors contributed to data analysis, drafting or revising the article, have agreed on the journal to which the article was submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

Johnan Turyasingura reports grants from Mbarara University of science and technology, during the conduct of the study. The authors report no other potential conflicts of interest in this work.

Additional information

Funding

Research reported in this publication was supported by the first Mile project. The content is solely the responsibility of the authors and does not necessarily represent the official views of the first mile project.