Scientific Poster Session II - Original Research

Original Research
  Sunday, October 13, 2024
  12:45 PM–02:15 PM

Abstract

Introduction: Sepsis is a life-threatening condition with well-established practice standards. The 2021 Surviving Sepsis Campaign Guidelines include nine updates pertaining to medication recommendations. This study's purpose was to understand current practices and opinions regarding the use of the new recommendations.

Research Question or Hypothesis: Does profession impact practices and opinions regarding addition of second-line vasopressor and corticosteroids in septic shock?

Study Design: Cross-sectional survey distributed electronically to Society of Critical Care Medicine members.

Methods: Demographics, practices, and opinions related to sepsis management were assessed. Respondents were grouped by profession (physician, pharmacist, advanced practice providers [APP], nurses). Outcomes included knowledge and use of guideline recommendations to initiate second-line vasopressor based on norepinephrine rate and to initiate adjunctive corticosteroids based on norepinephrine rate and duration. Outcomes were compared using the Chi-squared test. Logistic regression was applied. SPSS Version 29 was used with alpha <0.05 considered significant.

Results: Four-hundred eighty-five clinicians participated in the survey, including 62.7% physicians, 15.5% pharmacists, 17.3% advanced practice providers, and 4.5% nurses/other. Pharmacists (82%) were more aware of the guideline recommendation statement on adding second-line vasopressors compared to physicians (62%), APPs (50%) and nurses (32%) (p<.001); however, the use of this recommendation in practice was lower (41.5%) and was similar across clinician types. Similarly, pharmacists (78%) were more aware of the guideline recommendation statement on adding corticosteroids when compared to physicians (54%), APP (35%), and nurses (37%) (p<.001). This recommendation was infrequently applied in practice (4.9%) and was similar across professions. In multiple regression accounting for confounding variables, pharmacists remained more likely to be aware of guideline recommendations for adding a second-line vasopressor (OR 4.402, 95% CI 2.122-9.131) and corticosteroids (OR 6.510, 95% CI 3.170-13.368).

Conclusion: Although pharmacists reported higher awareness of guideline recommendations relating to addition of a second vasopressor to norepinephrine and addition of corticosteroid, the majority of all providers do not follow these SSC recommendations.

Presenting Author

Alexander Ruehman PharmD Candidate

Authors

Trisha N. Branan PharmD, BCCCP, FCCM
University of Georgia College of Pharmacy

Emma Covington BS, PharmD Candidate
Susan E. Smith PharmD, BCCCP, FCCM
University of Georgia College of Pharmacy