Emergency nurses knowledge and understanding of their role in recognising patients with sepsis: A clinical review

CN Amanda Harley1, Dr Amy Johnston2, Professor Julia Crilly2, Dr Debbie Massey3, Professor Gerben Keijzers1, Dr Kerina Denny1

1Gold Coast University Hospital, Southport Gold Coast, Australia, 2Menzies Health Institute Queensland Griffith University  and Gold Coast University Hospital, Southport Gold Coast, Australia, 3University of Sunshine Coast, Sippy Downs Sunshine Coast, Australia

Sepsis remains a significant cause of morbidity and mortality for patients who present to emergency departments (EDs); accounting for more than 500,000 ED visits per year. Early identification of sepsis is important, so that appropriate treatment regimens can be instigated in a time critical fashion. Existing guidelines focus on the treatment of sepsis once identified, but do not specify the role of nurses.

This study will use an exploratory case study research design to address current gaps in our understanding of the complex, poorly understood phenomena of ED nurse recognition of and response to patients with sepsis. This qualitative component of a wider mixed-methods study will draw on semi-structured interviews undertaken with ~20 ED nurses from a single health service who have cared for a patient with sepsis. Interviews will explore their perceptions and practices around recognising and responding to patients with sepsis, their awareness of/and familiarity with validated sepsis recognition tools and the barriers and benefits they identify from implementing such tools. Nurse understanding of evidence based practice will be reviewed in relation to the quick Sepsis Related Organ Failure Assessment (qSOFA) and Systemic Inflammatory Response Syndrome (SIRS) criteria.  Themes derived from the interview transcripts will be developed using an inductive approach. To limit risks of errors, and to ensure dependability, transferability, confirmability and credibility, clear analysis guidelines will be used.

Improvements in the care of the patient with sepsis is of local, national and international importance reflected by the emerging literature demanding the use of best evidence and guidelines. As part of a multi-disciplinary team, nurses have a vital role in the recognition and response to sepsis. The knowledge and insights gained from this study can be used to inform local and state-wide ED policies, and enrich educational packages that will improve quality of patient care and outcomes.


Amanda Harley is an experienced Clinical Nurse based at Gold Coast University Hospital Emergency Department. She is a passionate advocate for nurse involvement in development and implementation of evidence-based guidelines for recognition and management of patients with sepsis. Her academic qualifications inclusive of a Masters of Emergency Nursing and Graduate Diploma in Education, coupled with her current shared research, university teaching, and clinical roles, are helping her achieve these aims.

Amy Johnston is a conjoint research fellow in Emergency Care, based between Gold Coast Health and Menzies Health Institute Queensland. She is a widely published and cited academic and registered nurse with experience in a range of research techniques.