Highlights
- •There has been a call for greater participation in antibiotic stewardship by the entire health care team, including nurses.
- •There are limited available data evaluating nursing engagement in stewardship activities.
- •Nurses are well positioned to be part of the solution to preserve and promote appropriate antibiotic use; however, efforts are needed to cultivate an environment where nurse contribution is actively sought.
Background
Nursing has been called for greater participation in antibiotic stewardship. Although
many of the functions that are integral to successful stewardship are within the scope
of bedside nurses, data evaluating nursing engagement in stewardship are limited.
The objective of this study was to identify nurses' roles and confidence in engaging
in stewardship practices by conducting a survey of pediatric staff nurses employed
at a 354-bed freestanding children's hospital with a well-established prospective
audit and feedback stewardship program.
Methods
An investigator-developed online survey was used to assess 10 identified practices
that fall within the responsibility of inpatient nurses and contribute to the stewardship
process.
Results
One hundred and eighty nurses participated in the study. Nurses were highly confident
assessing for an adverse drug reaction history, obtaining cultures prior to antibiotics,
and participating in patient education. They were less confident in reviewing microbiology
results to determine antibiotic appropriateness. Clinical practice and hospital culture
influenced perceptions of the nursing role in stewardship. Reported barriers to stewarding
included nurses not included in rounds, interdisciplinary power differentials, and
nursing input not actively sought.
Conclusions
Barriers to nurse engagement were identified and could be addressed by improving education
in microbiology and principles of antibiotic use along with more consistent inclusion
of nurses in bedside rounds while also cultivating an environment where nurse contribution
is actively sought.
Key Words
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Article info
Publication history
Published online: May 02, 2018
Footnotes
Previous presentation: Presented as a poster at Infectious Disease Week San Diego, CA, October 6, 2017.
Conflicts of interest: None to report.
Identification
Copyright
© 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
