Early Identification of Sepsis in Adults in Primary Care: A Pilot Project

Abstract

Problem: Sepsis is a nocuous host response to infection that leads to organ dysfunction and hypotensive shock. Now deemed a public health burden, sepsis is predicted to increase as the population in the United States ages. Recent research conducted by the Centers for Disease Control and Prevention concluded that 80 percent of sepsis begins outside of the hospital setting and that seven out of every ten patients diagnosed with sepsis recently used healthcare services. Because early identification helps to decrease mortality, it is imperative that family practice providers increase their awareness and recognition of sepsis so that treatment may be expedited. The problem is that primary care providers often lack knowledge and competence in recognizing the signs and symptoms of sepsis as well as the clinical judgment necessary to detect sepsis in its early stages. Clinical comprehension of sepsis has improved using simulation, a teaching modality with a long history in medical education. Purpose: The purpose of this project was to compare the knowledge and of primary care practitioners in the early recognition of sepsis using either high-fidelity simulation (HFS) or computer-based learning (CBL) with Kolb’s Learning Theory as the framework. Simulation has been shown to increase critical thinking and self-confidence through re-creation and reflection in a safe environment. Method: Family nurse practitioners (FNP) and advanced FNP students (FNPS) in the greater Kansas City area were recruited and randomly placed into CBL or HFS groups for this quasi- experimental design that included a clinical scenario, a 10-question pretest/posttest and a competence scale. Conclusion: Although this pilot lacked statistical significance, the results may be of use to inform future studies or other advanced simulation experiences.