Prompt Identification of Sepsis on Hospital Floors: Are Healthcare Professionals Ready for the Implementation of the Hour-1 Bundle?

Sadia Shakeel; Wajiha Iffat; Shagufta Nesar; Sidra Shayan; Aatka Ali; Márió Gajdács; Shazia Jamshed

doi:10.3390/tropicalmed7100291

Prompt Identification of Sepsis on Hospital Floors: Are Healthcare Professionals Ready for the Implementation of the Hour-1 Bundle?

Trop Med Infect Dis. 2022 Oct 10;7(10):291. doi: 10.3390/tropicalmed7100291.

Authors

Sadia Shakeel¹, Wajiha Iffat², Shagufta Nesar³, Sidra Shayan¹, Aatka Ali⁴, Márió Gajdács⁵, Shazia Jamshed⁶

Affiliations

¹ Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Dow College of Pharmacy, Dow University of Health Sciences, Karachi 74200, Pakistan.
² Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Dow College of Pharmacy, Dow University of Health Sciences, Karachi 74200, Pakistan.
³ Jinnah College of Pharmacy, Sohail University, Karachi 74000, Pakistan.
⁴ Department of Pharmaceutics, Faculty of Pharmacy, Hamdard University, Madinat al-Hikmah, Hakim Mohammad Said Road, Karachi 74600, Pakistan.
⁵ Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, 6720 Szeged, Hungary.
⁶ Clinical Pharmacy and Practice, Faculty of Pharmacy, Universiti Sultan Zainal Abidin, Kuala Terengganu 21300, Malaysia.

Abstract

Early intervention in sepsis management with recognized therapeutic targets may be effective in lowering sepsis-related morbidity and mortality, although this necessitates timely identification of sepsis by healthcare professionals. The present study aimed to assess knowledge levels, attitudes, and agreement among physicians regarding the Surviving Sepsis Campaign (SSC) guidelines (more specifically, the Hour-1 bundle). A quantitative, descriptive, cross-sectional study was conducted among physicians working in different clinical settings in Karachi, Pakistan, using a self-administered questionnaire. The mean cumulative knowledge score of the respondents towards SSC was 6.8 ± 2.1 (out of 10), where a total of n = 127 respondents (51.62%) had a strong understanding of the SSC guidelines, compared to n = 78 (31.7%) and n = 41 (16.7%) respondents with fair and inadequate knowledge, respectively. The majorly known bundle elements by the respondents were to administer broad-spectrum antibiotics (89.8%, n = 221), the need for taking blood cultures before administering antibiotics (87.8%, n = 216), and measurement of blood lactate levels (75.6%, n = 186). Experienced physicians were more likely to use norepinephrine as the first-choice vasopressor (p < 0.001). Female respondents were more likely to consider the duration of antibiotic therapy to be determined according to the site of infection, the microbiological etiology, the patient’s response to treatment, and the likelihood of achieving adequate source control (p = 0.001). The current study concluded that respondents had an optimistic approach and frequently practice in accordance with the SSC guidelines, while some respondents were not up to date with the most recent guidelines. There is a need for further interventions and continuous medical education to encourage physicians towards appropriate use of the recommended guiding principles for improving treatment outcomes in sepsis patients.

Keywords: Pakistan; Surviving Sepsis Campaign; bundles; developing country; emergency medicine; healthcare professionals; healthcare systems; knowledge; physicians; sepsis.

Grants and funding

M.G. was supported by the János Bolyai Research Scholarship (BO/00144/20/5) of the Hungarian Academy of Sciences. The research was supported by the ÚNKP-22-5-SZTE-107 New National Excellence Program of the Ministry for Innovation and Technology from the source of the National Research, Development and Innovation Fund. M.G. would also like to acknowledge the support of ESCMID’s “30 under 30” Award. Part of the APC was kindly funded by the Tropical Medicine and Infectious Disease (MDPI) Editorial Office.