Sepsis knowledge, skills and attitudes among ward-based nurses

Sepsis has traditionally been defined as a systemic inflammatory response syndrome (SIRS) with a suspected source of infection, which can be life threatening and lead to organ dysfunction when it is not recognised and treated early (Daniels, 2010). In 2016 an international consensus redefined sepsis as a ‘life-threatening organ dysfunction caused by a dysregulated host response’ (Singer et al, 2016). This new definition of sepsis identified patients who have evidence of organ dysfunction, previously recognised as severe sepsis, and abandoned SIRS as a definition. The use of two or more SIRS criteria to identify sepsis was no longer recommended, since most patients in hospital have changes in white cell count, temperature and heart rate, but may never develop infection; these parameters reflect the signs of inflammation in the form of infection, but do not necessarily indicate a dysregulated, life-threatening response (Singer et al, 2016). However, the Sepsis Trust has acknowledged that the SIRS criteria are still relevant in the identification of infection (also known as uncomplicated sepsis prior to 2016), and individuals who are at risk of developing sepsis (Daniels and Nutbeam, 2017), which explains why the SIRS criteria are still used in clinical practice.