Bedside nurses' antimicrobial stewardship practice scope and competencies in acute hospital settings: A scoping review

Abstract

AimTo identify and map bedside nurses' practice scope and competencies regarding antimicrobial stewardship in acute hospital settings, and develop a competency framework for them.BackgroundAntimicrobial stewardship requires multidisciplinary engagement including nursing. However, bedside nurses' antimicrobial stewardship practice scope and competencies in acute hospital settings remain unclear.DesignScoping review.MethodsUsing a five‐stage framework proposed by Arksey and O'Malley and following the Preferred Reporting Items for Systematic reviews and Meta‐Analyses extension for Scoping Reviews guidelines.ResultsA total of 1422 records were retrieved, and 41 studies were included. In addition to the six practices recommended, this review summarized bedside nurses' contributions to five additional fields as well. Correspondingly, the competencies required by bedside nurses were summarized into eight domains: specialized knowledge, safety medication administration, leadership, education, diagnostic stewardship, infection prevention and control, professional development and professional quality.ConclusionNurses' practice scope overlaps greatly with routine nursing practice in antimicrobial stewardship, confirming the evidence that nurses are ideal partners in antimicrobial stewardship. This review developed a competency framework at both basic and advanced levels. Among them, professional knowledge is the foundation, while professional quality motivates nurses to participate. In addition to competency assessment, it can also be used for training and human resource deployment based on seniority or professional level. This could bridge the knowledge gap and improve the engagement of nurses in heavy workload situations.Relevance to clinical practiceThis practice scope will provide opportunities for nurses to engage in antimicrobial stewardship. Moreover, nursing competencies identified in this field could facilitate the development of competency‐based education interventions, talent assessments, training and recruitment programs.Data resourcesPubMed, EMBASE, Web of Science, CINHAL, PsycINFO, Cochrane Library, ProQuest and Scopus were searched from inception to November 2022, with an updated search in March 2023.ImpactThis scoping review provides evidence for best nursing practice scope and competency in antimicrobial stewardship in hospitals. However, it is also in line with the commitment of all nurses in the global community to combat antimicrobial resistance, which has become a global threat. An antimicrobial stewardship competency framework for bedside nurses was developed at both the basic and advanced levels. It would facilitate talent assessment, training, recruitment and human resource management by guiding the development of competency‐based education interventions.Patient or Public ContributionNo Patient or Public Contribution.

Research priorities for nurses in antimicrobial stewardship in a middle-income country: a nominal group technique study

“…Despite the substantial number of studies conducted in Europe, the United States, and Australia that examine the signi cance of nursing in ASP (11,18,19,21,23,(34)(35)(36)(37)(38)(39)(40), there persists a lack of knowledge regarding the role of nurses in these programs in Brazil. As up to our knowledge there is no similar study on research priorities for the nurses' role in ASP.…”

Nurses’ engagement in antimicrobial stewardship and its influencing factors: A cross-sectional study

“…A self-assessment questionnaire was used to assess participants’ general characteristics. It consisted of all potential influencing factors related to nurse AMS engagement under the following two categories based on the literature review [ [12] , [13] , [14] , [15] ]: 1) socio-demographic factors, including gender, age, professional title, years working as a nurse, and education degree; 2) work-related factors, including whether working as a part-time infection control nurse, whether knowing the AMS team, whether knowing the defined daily doses of antibiotics, hospital type, department, deployment of clinical pharmacists in the department, frequency of antimicrobial training, and frequency of physician-nurse joint rounds.…”

“…A wide range of influencing factors have been identified as barriers or enablers to affect nurses’ AMS engagement, which can broadly be classified into two categories: socio-demographic (such as age, gender, education level, title, and working years) and work-related factors (such as the types of hospital and department, previous knowledge, experience, and training of AMS) [ [12] , [13] , [14] , [15] ]. Specifically, AMS-related education and training have been consistently emphasized in almost all studies, with well-established positive effects in improving nurses’ AMS engagement and patient outcomes [ [12] , [13] , [14] , [15] ]. However, localized assessment tools based on a theoretical framework are lacking in China to comprehensively examine nurses’ AMS engagement and influencing factors.…”