Integrating staff nurses in antibiotic stewardship: Opportunities and barriers.

Creator(s)

Elizabeth Monsees, Children's Mercy HospitalFollow
Lori Popejoy
Mary Anne Jackson, Children's Mercy HospitalFollow
Brian R. Lee, Children's Mercy HospitalFollow
Jennifer Goldman, Children's Mercy Kansas CityFollow

Document Type

Article

Publication Date

7-2018

Identifier

DOI: 10.1016/j.ajic.2018.03.028

Abstract

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.

Journal Title

American journal of infection control

Volume

46

Issue

7

First Page

737

Last Page

742

MeSH Keywords

Anti-Bacterial Agents; Antimicrobial Stewardship; Cross-Sectional Studies; Hospitals, Pediatric; Humans; Nurse's Role; Nurses; Prospective Studies; Surveys and Questionnaires

Keywords

Antibiotic stewardship; antimicrobial stewardship; barriers; nursing; pediatric; survey

Recommended Citation

Monsees E, Popejoy L, Jackson MA, Lee B, Goldman J. Integrating staff nurses in antibiotic stewardship: Opportunities and barriers. Am J Infect Control. 2018;46(7):737-742. doi:10.1016/j.ajic.2018.03.028