Nurses are underutilised in antimicrobial stewardship e Results of a multisite survey in paediatric and adult hospitals

Authors

Mona Mostaghim, Sydney Children's Hospital, University of Technology Sydney
Thomas Snelling, Princess Margaret Hospital for Children, Charles Darwin University, University of Western Australia
Brendan J. McMullan, Sydney Children's Hospital, University of New South Wales
Pamela Konecny, University of New South Wales, St. George Hospital
Stuart Bond, University of WollongongFollow
Suman Adhikari, University of New South Wales, St George Hospital / St George Private Hospital
Adriana J. Chubaty, Prince Of Wales Hospital, Randwick
Cathy Lovell, Sydney Children's Hospital
Beata Bajorek, University of Technology Sydney

RIS ID

114730

Publication Details

Mostaghim, M., Snelling, T., McMullan, B., Konecny, P., Bond, S., Adhikari, S., Chubaty, A., Lovell, C. & Bajorek, B. (2017). Nurses are underutilised in antimicrobial stewardship e Results of a multisite survey in paediatric and adult hospitals. Infection, Disease & Health, 22 (2), 57-64.

Abstract

Objectives: Explore perceptions and attitudes of nurses in regard to antimicrobial stewardship (AMS), their roles as nurses, and identify differences in perceptions and attitudes across paediatric and adult settings. Methods: Electronic survey administered to nursing staff across three public Australian tertiary institutions with AMS facilitated by a shared electronic approval and decision support system. Results: Overall 65% (93/142) of nurses who completed the survey were familiar with the term AMS, and 75% recognised that they were expected to have a role alongside other disciplines, including ward pharmacists (paediatric 88%, adult 73%; p = 0.03). Hand hygiene and infection control (86%), patient advocacy (85%) and knowledge of antimicrobials (84%) were identified most often as AMS roles for nurses. However, 57% of nurses reported that their knowledge of antimicrobials was minimal or limited. Nurses generally agreed that requirement to obtain approval is an effective way to reduce inappropriate antimicrobial use (median scores: paediatric 2.0 [agree], adult 1.0 [strongly agree]; p = 0.001). Only 35% of paediatric and 58% of adult nurses perceived that their role includes ensuring approval for restricted antimicrobials (p < 0.01). Most nurses identified AMS teams (85%), pharmacists (83%) and infection control teams (paediatric 68%, adult 84%; p = 0.04) as sources of AMS support. Areas of interest for support and education included appropriate antimicrobial selection (73%) and intravenous to oral antimicrobial switch (paediatric 65%, adult 81%, p = 0.03). Conclusion: Nurses consider AMS activities within their roles, but are underutilised in AMS programs. Further engagement, education, support and acknowledgement are required to improve nursing participation.