Factors affecting early identification of sepsis among intensive care unit nurses at Muhimbili national hospital, Dar es salaam, Tanzania

Abstract

ABSTRACT Background: Sepsis accounted for 19.7% of all deaths worldwide in 2017 with 11 million deaths and 48.9 million new cases. Sepsis rates are higher in low- and lower-middle-income nations. Critically sick patients may experience multiple organ dysfunction and even death if quick diagnosis and therapy are not initiated within an hour. ICU nurses can actively participate in the detection of sepsis by continuously monitoring patients and starting treatment in accordance with protocols. Every patient must be evaluated for sepsis at the beginning of every shift in order to maximize the likelihood of detecting those who are at risk. Aim: To explore the factors affecting early identification of sepsis in nursing practice among Intensive Care Unit nurses working in adult ICUs at Muhimbili National Hospital, Dar es Salaam, Tanzania. Material and methods: This was explorative descriptive qualitative study design. Purposive sampling was used to recruit study participants. In-depth interviews were conducted to 14 ICU nurses at Muhimbili National Hospital. The interviews were digitally recorded, transcribed verbatim and analyzed using thematic analysis to develop themes. Results: Three main Themes emerged: individual factors, environmental factors and institutional factors affecting early identification of sepsis. The individualized experience and knowledge on sepsis identification, environmental factors being the nurse patient ratio and medical equipment for sepsis care, and in institutional factors being training on sepsis and availability of screening tools of sepsis to critically ill patients. Conclusion: Early sepsis identification is affected by a combination of individual, environmental and institutional factors. The more the individual’s knowledge and experienced are, with proper nurse patient ratio, with availability of screening tools and training the better they can recognize early signs of sepsis. Recommendations: Regular workshops, simulation-based training sessions, and continuing education credits can significantly improve nurses' proficiency in sepsis identification.

Key words: Sepsis, Early identification, Intensive Care Unit, Intensive Care Unit Nurse