Einflussfaktoren auf die eigene Anwendung der Sepsis-Kompetenz und ihre Förderung bei Patientinnen und Patienten: Ergebnisse einer Mixed-Methods-Studie mit Gesundheitsfachpersonen

Abstract

Background

Sepsis is a life-threatening and relatively common emergency which is often recognized too late or not at all. Therefore, the “SepsisWissen” (SepsisKnowledge) project aimed to bring about changes in health care professionals’ behavior in the area of sepsis prevention and early detection. It addressed the health care professionals themselves (e. g., their own vaccination, hygiene and early detection behavior) and their patient counseling behavior. To promote this behavior, the SepsisWissen campaign included offers such as trainings or print products. The subsequent core question is: From the health professionals’ perspective, which barriers and facilitators affect their own application of sepsis competence and their promotion of their patients’ sepsis competence?

Methods

This paper was based on a cross-sectional mixed-methods study part of “SepsisWissen” with

• a)

  semi-structured interviews with 17 providers and

• b)

  a quantitative survey among 135 providers.

Part a) was analyzed using qualitative oriented content analysis based on Mayring, part b) was analyzed descriptively.

The interviewees included physicians, nurses, pharmacists, assistants to physicians and pharmacists and, additionally, one paramedic in the quantitative sample. Some of them had attended “SepsisWissen” trainings.

Results

The qualitative data analysis identified 41 conducive and hindering factors, which can be assigned to the following eight major topics: 1) syndrome sepsis; 2) predisposing factors for health professionals' own acquisition and application of sepsis competence; 3) enabling factors for health professionals themselves; 4) behavior and lifestyle of patients; 5) reinforcing factors for patients; 6) public health education; 7) political, administrative, and organizational context; 8) environmental factors. In the qualitative and quantitative surveys, the suggestion to improve the sepsis competence of the population and to reduce misinformation, respectively, through public education (e. g., via schools or the media).

Discussion

Sepsis training for health professionals was considered as a facilitating factor for taking potential sepsis symptoms and patients’ respective statements more seriously. Future training formats should convey more explicitly how health professionals can better communicate their own sepsis knowledge to their patients. They request instruments to support their communication, such as checklists for lay persons. According to the interviews, health workers themselves need recurring external reminders for the topic of sepsis. Organizational and political conditions should be improved. From the health professionals’ point of view, it is essential to offer better reimbursement for prevention and counseling services and to allocate adequate time resources for both.

Conclusion

Health professionals could increase their potential to apply and promote sepsis competence if general conditions were optimized. From their perspective, it is most important to relieve them of some of their patient counselling burden by initiating more public education.