Journal of Global Infectious Diseases

LETTER TO EDITOR
Year
: 2015  |  Volume : 7  |  Issue : 2  |  Page : 90--91

Resident medical officer's knowledge of sepsis: A qualitative study


Nata Pratama Hardjo Lugito, Andree Kurniawan, Margaret Merlyn Tjiang, Theo Audi Yanto, Indra Wijaya, Resa Setiadinata, Stevent Sumantri, Euphemia Seto 
 Department of Internal Medicine, Siloam Karawaci General Hospital, Pelita Harapan University, Tangerang, Banten, Indonesia

Correspondence Address:
Nata Pratama Hardjo Lugito
Department of Internal Medicine, Siloam Karawaci General Hospital, Pelita Harapan University, Tangerang, Banten
Indonesia




How to cite this article:
Hardjo Lugito NP, Kurniawan A, Tjiang MM, Yanto TA, Wijaya I, Setiadinata R, Sumantri S, Seto E. Resident medical officer's knowledge of sepsis: A qualitative study.J Global Infect Dis 2015;7:90-91


How to cite this URL:
Hardjo Lugito NP, Kurniawan A, Tjiang MM, Yanto TA, Wijaya I, Setiadinata R, Sumantri S, Seto E. Resident medical officer's knowledge of sepsis: A qualitative study. J Global Infect Dis [serial online] 2015 [cited 2019 Aug 19 ];7:90-91
Available from: http://www.jgid.org/text.asp?2015/7/2/90/146384


Full Text

Sir,

Sepsis is frequent and is responsible for high mortality. [1] Mortality in the hospital ranges 20.7-55.2% for severe sepsis and 40.9-60.5% for septic shock. [2],[3] To overcome this problem, the Surviving Sepsis Campaign guidelines were developed and published in 2004 and then updated in 2008 and 2012. [4] Observation of clinical signs such as consciousness, heart rate, blood pressure, respiratory rate, body temperature, and urine output is essential to make an early intervention in the care of sepsis patients. However, early detection of clinical signs of the critically ill patient by hospital staff was frequently delayed. [5] This qualitative study was performed in a general hospital in Karawaci District, Banten Province, Indonesia in September 2014. Its aim was to investigate the knowledge of 25 resident medical officers (RMOs), as a component of hospital staff, of sepsis based on the 2012 Surviving Sepsis Campaign guidelines. RMOs are physicians attending patients in the emergency unit, the wards, and the intensive care unit (ICU). Characteristics of RMOs who participated in the survey are shown in [Table 1].{Table 1}

The findings showed that the knowledge of the RMOs in recognizing the signs of sepsis was still insufficient, but that the knowledge of the RMOs in managing sepsis was sufficient, although still in need of improvement [Table 2]. This contrasts with the fact that 88.0% RMOs studied sepsis when they were in medical school. {Table 2}

Inadequacy in treatment is due to insufficiently trained or busy or inexperienced staffs. [5] As the knowledge of the RMOs about the definition, clinical signs, and spectrum of sepsis is insufficient, it is predictable that many sepsis patients would have been underdiagnosed. The RMOs may be able to detect the abnormal clinical signs, but the importance of those signs is not understood, and thus appropriate and effective treatment cannot be initiated. Even though the RMOs have fairly good basic knowledge of managing sepsis, it will not be of any use if they cannot diagnose it.

References

1Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR. Epidemiology of severe sepsis in the United States: Analysis of incidence, outcome and associated costs of care. Crit Care Med 2001;29:1303-10.
2Esteban A, Frutos-Vivar F, Ferguson ND, Peñuelas O, Lorente JA, Gordo F, et al. Sepsis incidence and outcome: Contrasting the intensive care unit with the hospital ward. Crit Care Med 2007;35:1284-9.
3Martin CM, Priestap F, Fisher H, Fowler RA, Heyland DK, Keenan SP, et al.; STAR Registry Investigators. A prospective, observational registry of patients with severe sepsis: The Canadian sepsis treatment and response registry. Crit Care Med 2009; 37:81-8.
4Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al.; Surviving Sepsis Campaign Guidelines Committee including The Pediatric Subgroup. Surviving sepsis campaign: International guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med 2013;39:165-228.
5Watkinson PJ, Barber VS, Price JD, Hann A, Tarassenko L, Young JD. A randomized controlled trial of the effect of continuous electronic physiological monitoring on the adverse event rate in high risk medical and surgical patients. Anaesthesia 2006;61:1031-9.