Department of Surgery and Anaesthesia, University of Otago, Wellington, New Zealand.
Wellington Emergency Department, Wellington Regional Hospital, Wellington, New Zealand.
Emerg Med Australas. 2022 Jun;34(3):417-427. doi: 10.1111/1742-6723.13911. Epub 2021 Dec 9.
Early sepsis recognition and treatment are essential in order to reduce the burden of disease. Initial assessment of patients with infection is often undertaken by ED nurses and resident doctors. This descriptive qualitative study aimed to explore their perceptions and perspectives regarding the factors that impede the identification and management of patients with sepsis.
This was a qualitative study conducted between 30 January 2020 and 27 February 2020. Semi-structured focus group interviews were performed to collect data. All participants provided written informed consent and completed a basic demographic and work experience form. Two study investigators facilitated the interviews. Interviews were audio-recorded and later transcribed. Thematic analysis was performed with the aid of NVivo 12 software.
Six focus group interviews were conducted involving 40 ED nurses and doctors. Interview length ranged from 27 to 38 min (mean 33.5 min). Three major themes were identified: (i) clinical management; (ii) challenges and delays; and (iii) communication. Each of these themes was broken down into subthemes, which are presented in more detail.
ED nurses and doctors have identified important factors that limit and enhance their capacity to recognise and respond to patients with sepsis. Complex interactions exist between clinical and organisational structures that can affect the care of patients and the ability of clinicians to provide optimal care. The three major themes and specific subthemes provide a useful framework and stimulus for service improvements and research that could help foster future sepsis management improvement strategies.
为了减轻疾病负担，早期识别和治疗脓毒症至关重要。感染患者的初步评估通常由急诊科护士和住院医生进行。本描述性定性研究旨在探讨他们对阻碍脓毒症患者识别和管理的因素的看法和观点。
这是一项于 2020 年 1 月 30 日至 2 月 27 日期间进行的定性研究。采用半结构式焦点小组访谈收集数据。所有参与者均提供书面知情同意书，并填写基本的人口统计学和工作经验表格。两名研究调查员协助进行访谈。访谈进行了录音，然后进行了转录。借助 NVivo 12 软件进行了主题分析。
共进行了六次焦点小组访谈，涉及 40 名急诊科护士和医生。访谈时长从 27 分钟到 38 分钟不等（平均 33.5 分钟）。确定了三个主要主题：（i）临床管理；（ii）挑战和延迟；（iii）沟通。每个主题都细分为子主题，更详细地呈现。
急诊科护士和医生已经确定了限制和增强他们识别和应对脓毒症患者能力的重要因素。临床和组织结构之间存在复杂的相互作用，会影响患者的护理和临床医生提供最佳护理的能力。三个主要主题和具体的子主题为服务改进和研究提供了一个有用的框架和激励，这有助于培养未来脓毒症管理改进策略。
