Knowledge, Attitudes and Practices of Sepsis Management at Moi Teaching and Referral Hospital, Kenya

Background: This study aimed to describe sepsis related intervention practices among health care providers within a referral center in Kenya. Methods: Knowledge Attitude and Practice (KAP) surveys assessing sepsis related activities were distributed to health care providers at the Moi Teaching and Referral Hospital (MTRH) in Eldoret, Kenya. The target population was physicians, clinical officers, and nurses working in the Intensive Care Unit (ICU), casualty (emergency) and medicine wards in July 2014. Results: The response rate was 100% (86/86). Crystalloid fluids were the most common resuscitation fluids. About 80% of the providers in the medicine wards and casualty department utilized the drop count method. Fifty percent of providers at the ICU reported using intravenous fluid pumps. The most common reported cause of sepsis was respiratory infections. The most common reported antibiotics were ceftriaxone and metronidazole. All providers at casualty reported having access to these antibiotics, while only 75% of providers at the ICU indicated that they had access to antibiotics (p = 0.018). Only 43% of providers reported ordering blood cultures as the initial investigation in patients with sepsis. Invasive catheters were mostly unavailable in the ICU and casualty departments. Common reported barriers to providing care included advanced patient presentation, lack of antibiotics, and lack of sufficient staff. Conclusion: Providers reported a severe lack of invasive critical care equipment across all departments. Participant reported that lack of broad-spectrum antibiotics, lack of staff and lab test and equipment severely hinder optimal management of sepsis in this setting.