Physician's knowledge, approach, and perceived barriers to the diagnosis and management of sepsis in a public tertiary hospital in Lagos, Nigeria: A cross-sectional study

Background: Low protocol adherence hinders sepsis care in Nigeria. This study assessed the knowledge, strategy, and perceived barriers of physicians to prompt detection and treatment of sepsis. Methods: The researchers conducted a cross-sectional survey of physicians at Lagos University Teaching Hospital (LUTH). Participation was open to all LUTH physicians. Between June and December 2022, a self-administered questionnaire was sent to the platforms of physicians. Participants' mean scores on knowledge, approach, and barriers to sepsis care were calculated. Analysis of variance was used to compare the mean scores between physician cadres. A 0.05 two-sided P value was deemed statistically significant. Results: The study included 165 physicians. The mean age (standard deviation) was 38.25 (9.7), with 92 (55.8%) males. Only eight (4.8%) physicians had a 75% comprehension of sepsis. Only three respondents (1.8%) achieved 75% on sepsis care per surviving sepsis campaign standards. One hundred and thirty-eight (83.6%) respondents indicated significant barriers to sepsis treatment. Senior registrars had higher knowledge scores, while interns scored lowest (F = 3.508, P = 0.009). The mean scores of approaches to sepsis care among cadres were not significant (F = 1.692, P = 0.154). Conclusion: This study revealed that clinicians in a tertiary hospital in Lagos, Nigeria, had inadequate knowledge, especially among lower cadre doctors, and a suboptimal approach to the management of sepsis patients, as well as substantial barriers to their care. There is a need to provide physicians with tailored training on the diagnosis and correct approach to the care of patients with sepsis, as well as provide job aids to help with decision-making in the emergency rooms.