Health care system leaders' perspectives on infection preventionist and registered nurse engagement in antibiotic stewardship

Abstract

Infection preventionists (IPs) and registered nurses (RNs) have an important role to play in antibiotic stewardship programs (ASPs). Recent articles highlight their potential roles in practice, research, education, and policy; however, little is known about their actual ASP engagement. Leaders often have early knowledge of emerging trends and evolving health care worker roles. A survey was developed using the Centers for Disease Control and Prevention's Core Elements of Hospital Antibiotic Stewardship Programs to assess health care system infection prevention and control leaders' perceptions of IP and RN engagement in hospital ASPs. Thirty-five leaders representing all regions of the United States completed the survey. Their organizations tended to have significant ASP leadership support, but lacked ASP policies indicating IP and RN roles and responsibilities. IPs were more likely than RNs to be members of the ASP team and have greater ASP knowledge. Neither discipline was conducting patient education related to proper use of antibiotics, but this was identified as a future ASP role. The 2017 Joint Commission Antimicrobial Stewardship Standard was accelerating ASP implementation. IPs and RNs are well-positioned to assume greater roles in ASPs, especially in educating patients about the safe and proper use of antibiotics. However, their roles must be clearly identified, defined, and quantified. In so doing, knowledge and skill gaps can be identified and specific educational programs developed to advance their successful engagement in ASPs.