Appendix A. Knowledge Questionnaire Completion of this questionnaire is optional and implies informed consent.
Please answer every question to the best of your ability.
1. A patient would be considered to have acute mental status changes if their Glasgow Coma Scale score is:
a. 25 minutes b. 20 minutes c. 15 minutes d. 13 minutes
2. This vital sign is the most sensitive when identifying early sepsis:
a. Heart rate b. Respiratory rate c. Oxygen saturation d. Temperature e. Blood pressure
3. Which of the following are non-invasive assessments that could be completed to assess perfusion?
a. Delayed capillary refill b. Cool extremities c. Diminished pulses d. Mottling of extremities e. All of the above
4. Best practice for treatment of sepsis is initiation of treatment within 6 hours.
a. TRUE b. FALSE c. I don’t know
5. When I notice that the patient fulfills the criteria of sepsis, I should inform my colleagues directly.
a. TRUE b. FALSE c. I don’t know
6. Early treatment for sepsis includes screening for infection, organ dysfunction and hypotension.
a. TRUE b. FALSE c. I don’t know
7. Which of the following are NOT concerning for developing sepsis:
a. Altered mental status b. Tmax > 100F
c. Lactic acid < 2 mmoL d. WBC > 12,000 mm3 e. Respiratory rate >22
8. The qSOFA tool for scoring sepsis is used in my place of work to detect deterioration.
a. TRUE b. FALSE c. I don’t know
9. Which of the following are criteria for the qSOFA scoring tool:*
a. Altered mental status b. Tmax > 100F
c. Systolic blood pressure d. WBC > 12,000/mm3 e. Respiratory rate
10. Which of the following in NOT a risk factors for sepsis:
a. Advanced age b. Female gender
c. Presence of pulmonary infection d. African American
e. Tobacco use
Adapted with permission by Stamataki et al. (2013)
