Nurses' knowledge and implementation of antimicrobial stewardship and infection prevention strategies in acute paediatric settings

Abstract

Nurses are the first point of contact for patients and are responsible for monitoring and reporting signs of infection. The COVID-19 pandemic cemented nurses' leadership role in infection prevention. Despite this, nurses' contribution to Antimicrobial Stewardship initiatives remains under-recognised. The aim in this study was to determine how paediatric nurses understood their role and contribution to antimicrobial stewardship and infection prevention and control practices in three different acute paediatric wards. Forty-three nurses were recruited from an adolescent ward, an oncology ward and a surgical ward in a metropolitan tertiary children's hospital for a qualitative exploratory descriptive study. Thematic and content analysis derived three themes from the data: Understanding of preventable infections, Embracing evidence-based guidelines to protect the patient, and Roles in preventing and controlling infections and antimicrobial stewardship. Associated subthemes were: Desensitised to COVID-19, Understanding Infection Prevention and Control Precautions, Correct Use of Hospital Policy and Guidelines, Restrictions Associated with the Use of Electronic Medical Records, Understanding of Sepsis Management and the Importance of Timely Micro-Biological Testing, Ambivalence on Antimicrobial Stewardship roles, and High priority placed on consumer education. Nurses' understanding of their role focused on practices such as performing hand hygiene, standard precautions and reporting the use of high-risk antimicrobials. A lack of understanding of paediatric COVID-19 transmission and presentations was also reported. Education on best practice in infection prevention and AMS was recognised as crucial for both nurses and parents.