Implementation of a nurse-driven antibiotic engagement tool in 3 hospitals.
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.
American journal of infection control
Antibiotic stewardship; Duration; Interprofessional communication; Leadership; Nurses
Monsees, E., Lee, B. R., Wirtz, A. L., Goldman, J. Implementation of a nurse-driven antibiotic engagement tool in 3 hospitals. American journal of infection control 48, 1415-1421 (2020).