Implementation of a nurse-driven antibiotic engagement tool in 3 hospitals.

Document Type

Article

Publication Date

12-2020

Identifier

DOI: 10.1016/j.ajic.2020.07.002

Abstract

BACKGROUND: Nurses are key in implementing antibiotic stewardship; however, standardized processes are lacking.

METHODS: This feasibility study tested implementation of a nurse-driven antibiotic engagement tool (AET) that addressed antibiotic indication, duration, discontinuation, and intravenous to oral conversion. An investigator-developed survey measured nurse satisfaction, confidence, and understanding of antibiotic plan of care among 4 clinical units. Mann-Whitney U was used to compare differences between time periods. Nonparametric summary distributions assessed AET use.

RESULTS: Results from 121 surveys were available; 71 (36%) presurvey, 50 (24%) postsurvey. Thirteen registered nurses reported satisfaction or agreement with AET use: (1) ease (median: 4 [2.25, 4]); (2) time (median: 4 [3.5, 4.5]); (3) helped facilitate asking questions (median: 4 [3, 4]); (4) helped find antibiotic information (median: 4 [2.5, 4]); and (5) increased confidence in antibiotic discussions (median 4 [3, 4]). Planned duration of antibiotic therapy was unclear to nurses 13.9% of the time with nurses identifying duration discrepancies in 22.8% of submitted AETs.

CONCLUSIONS: The AET promoted interprofessional conversation. Use was higher in settings where leaders and nurse influencers were involved in stewardship promotion. Clarifying antibiotic duration is a prime area for future nursing antibiotic stewardship efforts.

Journal Title

American journal of infection control

Volume

48

Issue

12

First Page

1415

Last Page

1421

Keywords

Antibiotic stewardship; Duration; Interprofessional communication; Leadership; Nurses

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