Abstract
Background: To investigate the current status and problems of sepsis guidelines in clinical application among doctors in tertiary hospitals in China and to provide evidence-based case for the formulation, implementation, and training on sepsis diagnosis and treatment.Methods: Physicians from tertiary hospitals, mainly in emergency and critical care departments were enrolled into the survey. Participants completed a questionnaire on sepsis score, diagnostic indicators, fluid resuscitation, antibiotics choice, access to knowledge and application training, and the application of sepsis guidelines in clinical diagnosis and treatment. Results: Of 661 questionnaires that were distributed, 625 were returned. A total of 432 (69.12%) respondents had junior and intermediate professional titles and 193 (30.88%) had senior titles. Among them, 291 (46.56%) were self-taught, 148 (23.68%) were attending lectures, 153 (24.48%) were assigned ward rounds by senior doctors, 9 (30.88%) were taught in other ways, and 24 (3.84%) had no training. To learn about sepsis guidelines, 36.64% of respondents preferred attending lectures, 34.72% chose to study by themselves, and 27.04% preferred listening to senior doctors. Regarding the best way to learn about sepsis guidelines, 42.08% preferred to read by themselves, 41.76% preferred attending lectures, and 14.72% preferred listening to senior doctors. For formulation and implementation of sepsis diagnosis and treatment strategy, >90% of the respondents thought that they needed to rapidly give patients large volumes of fluid replacement but were not satisfied, while 89.6% doctors agreed that rehydration should follow the principle of “use with vasoactive drugs, not too much”. Of the respondents, 61.92% preferred empirical drugs in the use of sepsis antibiotics, 34.56% preferred high-level antibiotics with a wide coverage strategy, 2.4% would choose following instructions by senior doctors, and 0.16% did not know how to choose. Over 70% of the doctors surveyed thought that self-study guide, attending lectures, and senior doctors’ ward rounds were the most important factors affecting drug use, while 47.68% said that the information found on the internet was an important way of guiding drug use.Conclusion: Although the prevalence of sepsis guidelines is high among doctors in tertiary Chinese hospitals, homogeneity of clinical application is poor and greatly affects diagnosis and treatment. Thus, standardized training for sepsis diagnosis and treatment is needed.
Survey on the current status of the diagnosis and treatment of pancreatic cancer in public tertiary hospitals in China
