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Background: Sepsis is one of the most challenging and complex clinical states, with persistently high mortality rates. Guidelines recommend the early identification of sepsis patients and immediate initiation of the Hour-1 Bundle treatment to reduce mortality from sepsis. Emergency nurses play a vital role in the early screening of sepsis. Studies indicate that mind mapping and In-Situ Simulation (ISS) training not only aid healthcare professionals in reinforcing theoretical knowledge retention but also enhance skills in coordination, task management, and communication during simulation exercises. This, in turn, promotes the effective implementation of various treatments during resuscitation. The combination of theoretical and practical training methods is more effective than a single training approach. In June 2023, our hospital's emergency department conducted training for emergency nurses on sepsis mind mapping combined with ISS. Objective: To explore the effect of mind mapping combined with ISS training in promoting the emergency nurses' implementation of the Hour-1 Bundle in sepsis patients. Methods: Using mind mapping and ISS training methods, 24 emergency nurses were divided into 6 groups for a 12-week training period. The study compared their pre- and post-training knowledge of sepsis, identification and diagnostic time, Hour-1 Bundle treatment completion rate, and non-technical skill scores. Post-training, the emergency nurses evaluated the effectiveness of the training. Results: The scores for sepsis knowledge among emergency nurses before and after training were 44.17 ± 9.21 and 60.42 ± 5.29, respectively. The identification and diagnostic times (hours) were 0.63 ± 0.18 and 0.49 ± 0.13, respectively. The Hour-1 Bundle treatment completion rates were 58.33% and 85.7%, respectively. There was a significant increase in all non-technical skill scores, with statistical significance (P < 0.05, P < 0.001). After two ISS trainings, the SET-M scores progressively increased, indicating a high satisfaction rate among nurses with the mind mapping and ISS training. Conclusion: The combination of mind mapping and ISS training enables emergency nurses to identify sepsis earlier and promotes the effective implementation of the Hour-1 Bundle treatment in sepsis patients, while also enhancing their cognitive understanding of sepsis and non-technical skills. [ABSTRACT FROM AUTHOR]

Abstract Background Sepsis is one of the most challenging and complex clinical states, with persistently high mortality rates. Guidelines recommend the early identification of sepsis patients and immediate initiation of the Hour-1 Bundle treatment to reduce mortality from sepsis. Emergency nurses play a vital role in the early screening of sepsis. Studies indicate that mind mapping and In-Situ Simulation (ISS) training not only aid healthcare professionals in reinforcing theoretical knowledge retention but also enhance skills in coordination, task management, and communication during simulation exercises. This, in turn, promotes the effective implementation of various treatments during resuscitation. The combination of theoretical and practical training methods is more effective than a single training approach. In June 2023, our hospital's emergency department conducted training for emergency nurses on sepsis mind mapping combined with ISS. Objective To explore the effect of mind mapping combined with ISS training in promoting the emergency nurses' implementation of the Hour-1 Bundle in sepsis patients. Methods Using mind mapping and ISS training methods, 24 emergency nurses were divided into 6 groups for a 12-week training period. The study compared their pre- and post-training knowledge of sepsis, identification and diagnostic time, Hour-1 Bundle treatment completion rate, and non-technical skill scores. Post-training, the emergency nurses evaluated the effectiveness of the training. Results The scores for sepsis knowledge among emergency nurses before and after training were 44.17 ± 9.21 and 60.42 ± 5.29, respectively. The identification and diagnostic times (hours) were 0.63 ± 0.18 and 0.49 ± 0.13, respectively. The Hour-1 Bundle treatment completion rates were 58.33% and 85.7%, respectively. There was a significant increase in all non-technical skill scores, with statistical significance (P

Abstract Background Timely administration of antibiotics is one of the most important interventions in reducing mortality in sepsis. However, administering antibiotics within a strict time threshold in all patients suspected with sepsis will require huge amount of effort and resources and may increase the risk of unintentional exposure to broad-spectrum antibiotics in patients without infection with its consequences. Thus, controversy still exists on whether clinicians should target different time-to-antibiotics thresholds for patients with sepsis versus septic shock. Methods This study analyzed prospectively collected data from an ongoing multicenter cohort of patients with sepsis identified in the emergency department. Adjusted odds ratios (ORs) were compared for in-hospital mortality of patients who had received antibiotics within 1 h to that of those who did not. Spline regression models were used to assess the association of time-to-antibiotics as continuous variables and increasing risk of in-hospital mortality. The differences in the association between time-to-antibiotics and in-hospital mortality were assessed according to the presence of septic shock. Results Overall, 3035 patients were included in the analysis. Among them, 601 (19.8%) presented with septic shock, and 774 (25.5%) died. The adjusted OR for in-hospital mortality of patients whose time-to-antibiotics was within 1 h was 0.78 (95% confidence interval [CI] 0.61–0.99; p = 0.046). The adjusted OR for in-hospital mortality was 0.66 (95% CI 0.44–0.99; p = 0.049) and statistically significant in patients with septic shock, whereas it was 0.85 (95% CI 0.64–1.15; p = 0.300) in patients with sepsis but without shock. Among patients who received antibiotics within 3 h, those with septic shock showed 35% (p = 0.042) increased risk of mortality for every 1-h delay in antibiotics, but no such trend was observed in patients without shock. Conclusion Timely administration of antibiotics improved outcomes in patients with septic shock; however, the association between early antibiotic administration and outcome was not as clear in patients with sepsis without shock.

Background: Timely administration of antibiotics is one of the most important interventions in reducing mortality in sepsis. However, administering antibiotics within a strict time threshold in all patients suspected with sepsis will require huge amount of effort and resources and may increase the risk of unintentional exposure to broad-spectrum antibiotics in patients without infection with its consequences. Thus, controversy still exists on whether clinicians should target different time-to-antibiotics thresholds for patients with sepsis versus septic shock.Methods: This study analyzed prospectively collected data from an ongoing multicenter cohort of patients with sepsis identified in the emergency department. Adjusted odds ratios (ORs) were compared for in-hospital mortality of patients who had received antibiotics within 1 h to that of those who did not. Spline regression models were used to assess the association of time-to-antibiotics as continuous variables and increasing risk of in-hospital mortality. The differences in the association between time-to-antibiotics and in-hospital mortality were assessed according to the presence of septic shock.Results: Overall, 3035 patients were included in the analysis. Among them, 601 (19.8%) presented with septic shock, and 774 (25.5%) died. The adjusted OR for in-hospital mortality of patients whose time-to-antibiotics was within 1 h was 0.78 (95% confidence interval [CI] 0.61-0.99; p = 0.046). The adjusted OR for in-hospital mortality was 0.66 (95% CI 0.44-0.99; p = 0.049) and statistically significant in patients with septic shock, whereas it was 0.85 (95% CI 0.64-1.15; p = 0.300) in patients with sepsis but without shock. Among patients who received antibiotics within 3 h, those with septic shock showed 35% (p = 0.042) increased risk of mortality for every 1-h delay in antibiotics, but no such trend was observed in patients without shock.Conclusion: Timely administration of antibiotics improved outcomes in patients with septic shock; however, the association between early antibiotic administration and outcome was not as clear in patients with sepsis without shock. [ABSTRACT FROM AUTHOR]