Author: Sianny Guzman
Mentor: Dr. Prachi Singh
Abstract:
Sepsis is the leading cause of infant mortality worldwide, responsible for an estimated 25 million deaths annually. Early recognition and administration of treatment is essential to reducing mortality rates. Resident physicians, who are most often the first to encounter septic patients, play a crucial role in diagnosing and treating sepsis. This study aims to evaluate resident physicians’ knowledge of sepsis recognition and management through an electronic survey. The survey will assess understanding of medical definitions, common symptoms, initial management, treatment management, and protocols. Data will be analyzed for variations across training years and clinical exposure. Anticipated findings suggest that early-year residents may demonstrate significant gaps in knowledge, highlighting a need for additional targeted educational interventions.
Introduction:
Sepsis remains a leading cause of death in children worldwide, contributing to approximately 25 million deaths worldwide each year. Sepsis occurs when the body’s response to infection triggers widespread inflammation, tissue damage, and potential organ failure. Timely recognition and intervention are critical, as evidence shows that early treatment significantly reduces the risk of mortality. Clinical guidelines such as the Surviving Sepsis Campaign and Sepsis-3 emphasize the importance of timely administration of antibiotics, fluid resuscitation, and monitoring lactate within the first hour of recognition.
Despite these well-established protocols, delays in diagnosis and treatment remain common, which is often linked to differences in physician knowledge and training. Resident physicians are often the first to respond in emergency and inpatient settings. Their ability to identify sepsis early and initiate treatment directly impacts outcomes. Therefore, evaluating the knowledge of resident physicians is a crucial step toward closing gaps in sepsis management and improving patient outcomes.
Hypothesis/Objective:
It is anticipated that there are measurable gaps in resident physicians’ knowledge of pediatric sepsis recognition and management, depending on the amount of training a resident has. The objective of this study is to assess these gaps and provide recommendations to improve resident training protocols– when it comes to pediatric sepsis.
Methods:
A structured multiple choice survey was developed based on current sepsis guidelines. The survey will include questions on:
-Definitions of sepsis and septic shock
-Early indicators of sepsis
-Initial management of sepsis
-Treatment timelines and guideline adherence
-Contributing factors to their comfortability in administration of treatment
Participants:
Approximately 50 resident physicians at UCSF Benioff Children’s Hospital were invited to participate, but only 23 responded. Residents were invited across all residency levels.
Data Collection:
The survey was distributed online and responses were kept anonymous. Participation is completely voluntary, and results will only be accessible to study investigators.
Data Analysis:
Responses were analyzed using descriptive statistics to assess overall knowledge and contributing factors to their level of comfortability in treatment administration. Comparative analysis is performed using the Kruskal-Wallis test to evaluate correlations between knowledge scores, years of training, and amount of sepsis cases encountered.
Results:
The residents rated their confidence levels in treatment of sepsis on a scale of 1 to 5. 1 being not confident and 5 being very confident. First year residents averaged a score of 2 out of 5, second year residents averaged a 2.75, and third year residents averaged a 3.8. Their scores signify their confidence levels increase with the more years of hands-on experience they receive. Then, the residents were asked what contributed to their levels of comfortability, and 50% reported closer proximity to patients and nursing staff improved their ability to recognize sepsis and administer treatment. Next, their knowledge on classic sepsis symptoms was tested. The survey asked how many symptoms need to be present for them to begin to suspect sepsis before they begin intervention. It was expected that the majority of residents to recognize two or more vital signs present would indicate that treatment administration is necessary.. 86.7% of the residents responded that two or more signs of sepsis would indicate that the patient needed to be watched closely– proving the assumption right. The more experienced, third year residents, made up the majority of this statistic. As for protocols, 80% of residents reported that they call for their supervising attending once they suspect sepsis, which is the appropriate response.
Conclusion:
Sepsis continues to represent a major healthcare challenge, especially in pediatrics, and timely recognition remains critical for reduced mortality rates. Resident physicians must be adequately trained to recognize and manage sepsis effectively, since they are typically the first to respond in an emergency. The study concluded the hypothesis was correct in that more experienced resident physicians are better able to recognize and treat sepsis cases. Gaps in knowledge on basic protocol and contributing factors to their comfortability were revealed. This data will be used to inform targeted interventions, mainly for first year residents, to close the gap in their education that will ultimately enhance patient care and outcomes.
Edited by: Tammy Zhen
Leave a Reply