Knowledge and Recognition of Systemic Inflammatory Response Syndrome and Sepsis Among Pediatric Nurses

Tuesday, July 12, 2011: 8:30 AM

Alvin D. Jeffery, MSN, RN
Lisa Knapp, RN, MSN, MEd
Pediatric Intensive Care Unit, Cincinnati Children's Hospital Medical Center, Cincinnati, OH

Learning Objective 1: The learner will be able to verbalize the existence of a knowledge deficit among pediatric nurses regarding sepsis recognition.

Learning Objective 2: The learner will be able to explain the need for more emphasis to be placed on education regarding sepsis recognition in pediatric patients.

Purpose: A large amount of research demonstrates the importance of key interventions in reducing mortality rates of pediatric patients with sepsis (Dellinger et al., 2008).  In order for interventions to be initiated, however, assessment and recognition of declining status must occur.  Because nurses are the clinicians who typically spend the most time with patients, they must be knowledgeable in recognizing SIRS/sepsis and aware of the importance of prompt intervention.  There is no published evidence discussing pediatric nurses’ knowledge of SIRS/sepsis recognition. 

The purpose of this study was to assess acute and critical care pediatric nurses’ knowledge of SIRS diagnostic criteria, sepsis guidelines, and the importance of SIRS recognition.

Van Sell and Kalofissudis’ Theory of Nursing Knowledge/Wisdom and Nursing Praxis demonstrates a direct correlation between knowledge and practice and was the organizing framework for this study (Van Sell & Kalofissudis, 2002).  Because this study was as an assessment tool for determining nurses’ knowledge of SIRS/sepsis, this theory suggests a low or high score should correlate with a poor or exemplary practice, respectively.

Methods: This quantitative, correlational descriptive study included 242 acute and critical care pediatric nurses at a 490-bed urban pediatric hospital.  Participants completed an original questionnaire regarding SIRS criteria, sepsis guidelines, priority interventions, and attitude towards the importance of SIRS recognition. 

Results: Results demonstrated a significant knowledge deficit among participants in several key areas of SIRS/sepsis recognition.  The mean score was 60.8% ± 7.4%.  Item analyses demonstrated nurses easily recognize septic shock but have difficulty recognizing patients in earlier stages of the sepsis continuum.  Significant confusion was evident regarding the role of blood pressure and serum lactic acid levels in diagnosing sepsis. 

Conclusion: It is highly recommended that an educational intervention be created for acute and critical care pediatric nurses to aid them in recognizing sepsis in its earlier stages.