出版社:Utrecht University, Maastricht University, Groningen University
摘要:Introduction : Sepsis is a time dependent medical emergency that remains the leading cause of death from infection worldwide. Early recognition and prompt treatment is fundamental to increased survival rates and optimal outcome for survivors of severe sepsis and septic shock. The majority of sepsis is community acquired and approximately 70-80% of patients with sepsis present to the Emergency Department (CDC 2016). Lack of knowledge and awareness can result in late patient presentations and delayed treatment by healthcare professionals. Increased awareness and education are imperative to facilitate early recognition and prompt treatment of sepsis. This has contributed to a significant reduction in mortality rate in the last 50 years with acute myocardial infarction and is a driving force that motivates the essential need for sepsis awareness if a reduction in mortality is to be achieved. Theory/Method : The survey was designed to gain insight into general public and healthcare workers perceptions, knowledge and attitudes regarding sepsis. A Prospective, quantitative survey was performed using a structured predetermined questionnaire. Sample : A total of 1589 participants comprised of the general public (n=561) and healthcare workers (n=1028) from all 6 hospital groups in the Republic of Ireland. Healthcare workers included Consultants, Non Consultant Hospital Doctors, nurses/midwives, care/support staff, allied health professionals, clerical/administration staff, portering staff, medical/nursing students and others. Results/Discussions : 57% of the general population had heard of the term sepsis. The majority were aware of sepsis through social/conventional media (42%) or personal experience (23%). On further exploration 70% of the general public associated sepsis with a “bad infection” and/or “blood poisoning”. However, heart attack was considered by the general public to have the highest mortality rate. 94% of healthcare workers surveyed had heard of sepsis, with 71% having received college and/or hospital based sepsis education. The ‘Sepsis 2’ definition which describes sepsis as a “dysregulated immune response to infection i.e. infection and Systemic Inflammatory Response (SIRS)” was the most popular description of sepsis by all grades of doctors and nurses/midwives. However, 25% - 30% of all doctors and 29% of nurses/ midwives did not think you needed infection to develop sepsis. This was a significant finding as it is important to distinguish between awareness and actuaually being able to recognise and diagnose sepsis correctly. Conclusions : There is moderate general public awareness about the term sepsis but this is not coupled with an understanding of the true impact and potential mortality associated with sepsis. There is evidence of good sepsis awareness in healthcare workers probably largely due to hospital and/or college education. Results of this survey reflect the challenges for early recognition and treatment of sepsis not only in the general public but amongst healthcare professionals. Lessons learned : This body of work was essential as it allowed quantification of the awareness, attitudes and perceptions of sepsis. It will help guide the National Programme plan education and awareness requirements for successful implementation of the National Clinical Guidelines. A sepsis E-learning programme was launched on HSELand in September 2016 to ensure easy accessibilty to sepsis education for healthcare workers. Limitations : The majority of participants were accessed in a hospital setting. Some of the questions had too many variables in the answer which made measurement difficult. Suggestions for future research : A repeat National Survey with a larger general public sample to evaluate if there has been an increase in sepsis awareness and assess any change in attitudes and perceptions of sepsis.