Enhancing nurses’ future role in antimicrobial stewardship

Abstract

BackgroundAntimicrobial stewardship (AMS) requires a multidisciplinary approach to address the global emergence of antimicrobial resistance (AMR). Nurses have potential roles to influence appropriate antibiotic use. ObjectiveThe objective of the study was to investigate knowledge of registered nurses (RNs) on antibiotics, AMR and their understanding of AMS. DesignA cross-sectional survey design was used. Participants and SettingParticipants were RNs from the greater Auckland region of New Zealand. MethodsQualtrics (Provo, Utah, USA), an online survey tool was used to collect data for a three-month period. Descriptive and inferential data was analysed using IBM® SPSS® Statistics version 23. Statistical significance was established at P ≤ 0.05. ResultsTwo hundred and ninety-eight (N = 298) respondents completed the survey. The majority rated having ‘average’ knowledge of antibiotics and generally of AMR. Lack of knowledge about AMS (211/298, 71%) was viewed as the most challenging factor in integrating AMS in clinical practice. The majority (251/298, 84%) were unaware of AMS programme being implemented in the workplace despite its presence in major district health boards in Auckland. Educating patients on safe antibiotic use (292/298, 98%) and ensuring that antibiotics are initiated and administered at the correct time (289/298, 97%) were highly viewed as fundamental nursing roles as antimicrobial stewards. Younger nurses had higher expectations for antibiotics to be prescribed by their doctor for the common cold or flu than older nurses (means 2.19/5 and 1.75/5, P = 0.001). Expectations to receive antibiotics for these viral illnesses was also higher among less experienced than the more experienced RNs (means 2.21/5 and 1.64/5, P < 0.001). ConclusionNurses play an essential role in promoting AMS practices. However, a good understanding of antibiotics, AMR and AMS is needed to effectively embed these concepts in clinical practice. Hence, addressing these educational needs is of paramount importance.