Factors associated with sepsis knowledge and its relationship with clinical decision-making and professional autonomy among intensive care nurses: a cross-sectional study

Early recognition and timely management of sepsis are critical in intensive care. Although nurses’ knowledge is fundamental to sepsis care, its relationships with nursing decision-making and professional autonomy remain insufficiently understood. This study evaluated intensive care nurses’ sepsis knowledge and examined its relationships with nursing decision-making and professional autonomy. This cross-sectional study included 125 of 143 eligible intensive care nurses (response rate: 87.4%) working in the intensive care units of a university hospital using a total population sampling approach. Data were collected using the Sepsis Knowledge Questionnaire, the Nursing Decision-Making Instrument, and the Attitude Toward Professional Autonomy Scale. Descriptive statistics, non-parametric group comparisons, Spearman’s rank correlation analysis, and multiple linear regression were performed. The study was reported in accordance with the STROBE guidelines. The mean age of the participants was 30.06 ± 5.6 years, and the mean sepsis knowledge score was 20.24 ± 4.21 out of 30, with notable knowledge gaps across several recognition and management items. Sepsis knowledge showed weak positive correlations with the Nursing Decision-Making Instrument total score (rₛ = 0.239, p = 0.007) and work-related independence (rₛ = 0.220, p = 0.013); both associations remained statistically significant after false discovery rate correction (adjusted p = 0.034 for both). Higher Nursing Decision-Making Instrument scores indicate a greater tendency toward intuitive rather than analytical decision-making. In the multivariable analysis, previous sepsis training was associated with higher sepsis knowledge (B = 1.799, p = 0.025), whereas never having cared for patients with sepsis was associated with lower knowledge compared with frequent care (B = − 3.473, p = 0.037). ICU nurses demonstrated varying levels of sepsis knowledge, with important gaps remaining in specific recognition and management areas. Previous sepsis training was independently associated with higher sepsis knowledge, whereas lack of clinical exposure to patients with sepsis was associated with lower knowledge. These findings suggest that structured, evidence-based sepsis education combined with opportunities for practice-oriented learning and clinical exposure may be relevant to strengthening nurses’ sepsis knowledge. The findings should be interpreted in light of the study’s single-center, cross-sectional design. Not applicable.