Sjuksköterskors erfarenhet av att identifiera tidiga tecken på sepsis hos neonatal barn : en intervjustudie

Abstract

Background: Bacterial systemic infection (sepsis) in the neonatal (0-28 days old) infant is a potentially life threatening condition and requires rapid diagnosis and treatment. Upon arrival at the emergency department the infant is examined by a nurse who makes an assessment of the child’s condition. Triaging a neonatal infant is a demanding task since the infant’s clinical status can rapidly change. It is therefore desirable that the nurse who conducts the triage has considerable experience.

Aim: To investigate nurses’ experiences of identifying early signs of sepsis in neonatal infants.

Method: This study was conducted with a qualitative method. Data was collected through semi-structured interviews with six nurses working in two different paediatric emergency departments in Stockholm. The interviews were transcribed and analysed through content analysis.

Result: In the analysis two major themes emerged regarding nurses’ experiences of identifying sepsis in neonatal infants; challenges in the specific care situation and strategies for assessment. This study shows that the challenges nurses experience when identifying neonatal sepsis in infants are clinical concern and difficulties in assessment. The nurses use four strategies when assessing the ill child; they observe and take into account vital clinical identifiers, rely on clinical intuition, capture information from parents and ability to act from experience.

Conclusion: Nurses in paediatric emergency departments have good knowledge of which signs to look for when identifying sepsis in neonatal children. Even nurses with a wealth of experience describe significant challenges when it comes to identifying sepsis in neonatal children. To address these challenges triage nurses use a range of strategies in their assessment. It is important that the nurse is able to make a careful assessment of the child when it is admitted to the ward.