PURPOSE: Early Antibiotics administration is one of the most important elements of the sepsis guidelines that improve mortality. A sepsis protocol was implemented at our academic medical center in 2004 . Nurses and residents were given formal orientation prior to and during the implementation of the protocol. This study was conducted to evaluate the critical care team members understanding of the importance of early administration of antibiotics in a septic patient.
METHODS: Medical residents and critical care nurses were asked to rank in order of priority 7 elements of the sepsis guidelines, which include CVP >8, MAP > 65mmHg, Antibiotics, SVO2, central venous access, arterial line, and activated protein C evaluation. If administration of antibiotics was ranked as 1 or 2, it was defined to be high priority.Nurses and residents were asked if they received a formal orientation regarding the sepsis guidelines.
RESULTS: 75 residents and 67 nurses were surveyed.69% of the residents vs 55% of the nurses felt antibiotics is of high priority (p =0.08). 70% of residents and 35% of nurses received formal orientation of the sepsis protocol (p<0.001); of those residents who received orientation, 77% vs 23 % felt early administration of antibiotics to be the highest priority (p=0.05); of those nurses who received orientation, only 58% vs 42 % felt antibiotics to be of high priority(p=NS). There was significant inverse correlation between nurses years of experience and antibiotics as high priority( r=−0.353, p=0.01).
CONCLUSION: 1)Residents who received formal orientation had a better understanding of the importance of early antibiotic use. 2)Nurses who received formal orientation didn’t obtain a better understanding of the importance of early antibiotic use. 3)Nurses with more years of experience had a better grasp of the importance of early antibiotics.
CLINICAL IMPLICATIONS: In the future, it appears important to orient physician and nurses together as interdisciplinary teams in order to obtain a uniform approach in managing septic patients .The content of the sessions needs to be customized to team learning instead of individual education.
DISCLOSURE: Anas Hadeh, None.