Implementation of the Sepsis Six Care Bundle in ICU: Nurses' Perspectives from Kabwe Central Hospital

Abstract

Background: Sepsis remains a critical global health challenge, affecting 49 million people and causing 11 million deaths annually. It results from a dysregulated host response to infection, leading to life-threatening organ dysfunction. Timely diagnosis, evidence-based care, and appropriate treatment were essential for improving patient outcomes, particularly in intensive care settings. This study explored nurses' experiences with implementation of the Sepsis Six Care Bundle at Kabwe Central Hospital’s Intensive Care Unit (ICU).

Methods: An exploratory phenomenological study design was employed, with ethical clearance and permission obtained prior to conducting the study. Data collection involved in-depth interviews with ten (n=10) conveniently selected intensive care unit nurses. Audio recordings and field notes were transcribed verbatim, and thematic analysis was performed to identify key themes. Data coding and organization were facilitated using NVivo software to ensure systematic analysis and rigor in theme identification.

Results: Four major themes emerged: Nurses’ Approach to Sepsis Care, Collaborative Efforts, Strategies for Improving Sepsis Outcomes, and Barriers to Effective Management. Many nurses had limited familiarity with the Sepsis Six Care Bundle, leading to inconsistent implementation. Resource constraints, including inadequate supplies, staffing shortages, and lack of continuous education, hindered its effective use. However, teamwork, leadership support, and access to protocols facilitated better adherence.

Conclusion: The study highlighted challenges and enablers in implementing the Sepsis Six Care Bundle at Kabwe Central Hospital’s ICU. While some nurses were aware of the bundle, inconsistent application was evident due to resource constraints and limited training. Strengthening teamwork, leadership support, and structured education, along with optimizing resources, was crucial for sustainable implementation and improved patient outcomes. However, the study was limited by its small sample size and single-site focus, which could affect the generalization of findings. Further research with a larger, more diverse sample was recommended to gain broader insights.