Barriers to full ASP participation for nurses
The CDC and the Joint Commission have each highlighted the importance of nurses in successful ASPs.1,2 However, there is still work to be done in helping healthcare organizations recognize the impact nurses can have on AMR efforts and take steps to fully utilize the knowledge, skill, and hands-on patient experience of nurses.
“Unfortunately, many healthcare organizations in the US have not clearly defined, or more importantly, recognized the essential role the nurse plays in stewardship,” Bonanni says.
In a 2018 survey, 69.4% of nurses either agreed or strongly agreed that they understood the term antibiotic stewardship. Most wanted to be more involved in ASP efforts and 54% felt they already were stewards.3
According to the study authors, the overall survey results indicate that while nurses believe they have a role to play in antimicrobial stewardship efforts, they may need enhanced education related to antimicrobials in order to fulfill that role most effectively. Additionally, clinical practice and hospital culture may inﬂuence nursing perceptions of their role in antibiotic stewardship.3
Several opportunities exist for enhancing the contributions of nurses to ASPs, according to Bonanni. Some of these include providing continuing education in infectious disease (including microbiology and pharmacology) and establishing well-defined processes and outcome measures. “Some of those outcome measures could be percentage of cultures obtained prior to the first dose of antibiotics, percentage of antibiotics administered in a timely manner, identifying contaminated blood specimens, percentage of bedside rounds that include antibiotic time-outs, and having a percentage of nurses able to verbalize the indication for patients being on antibiotics,” she says.
In addition to addressing knowledge gaps for nurses, the CDC/ANA white paper identified other ways hospitals can engage nurses and foster their participation in ASPs.1 Some of these include developing specific content and messages for nurses as part of any effort to raise awareness about antibiotic use and resistance, encouraging nurse antibiotic stewardship champions at the unit level, and including nurses in stewardship rounds.
The bioMerieux Learning Lounge is a trusted source for education and insight regarding today’s most critical public health challenges. Read the full Q&A with Donna Bonanni, RN, MSN, here.