Covering more territory to fight resistance: considering nurses’ role in antimicrobial stewardship

Abstract

The potential contribution nurses can make to the management of antimicrobials within an inpatient setting could impact on the development of antimicrobial resistance (AMR) and healthcare associated infections (HCAIs). Current initiatives promoting prudent antimicrobial prescribing and management have generally failed to include nurses, which subsequently limits the extent to which these strategies can improve patient outcomes. For antimicrobial stewardship (AS) programmes to be successful, a sustained and seamless level of monitoring and decision making in relation to antimicrobial therapy is needed. As nurses have the most consistent presence as patient carer, they are in the ideal position to provide this level of service. However, for nurses to truly impact on AMR and HCAIs through increasing their profile in AS, barriers and facilitators to adopting this enhanced role must be contextualised in the implementation of any initiative.

Electronic prescribing system design priorities for antimicrobial stewardship: a cross-sectional survey of 142 UK infection specialists

“…However, other healthcare workers also play an important role in AMS at the individual patient level including junior and senior doctors, nurses, non-medical prescribers and ward pharmacists. [36][37][38][39][40][41] Inclusion of these professional groups in user-testing at the design stage of EPMA implementation is likely to be critical to the success of the proposed software features. Future surveys focussing on front-line prescribers and medication administrators are critical.…”

Residual volume in vials of antibiotics used in pediatrics

“…The residual volume results found still raise concerns about antibiotic management in the institution under study. It is worth mentioning that drug management programs have been implemented throughout many European hospitals, but nurse involvement has been limited even though it is described as being multidisciplinary in approach, which is due to the workload and high turnover of nursing staff (11) . Medication management depends on correct medical prescription, dispensing, preparation and administration aimed at the rational use of medicine.…”

“…Losses should be continuously avoided under penalty of being harmful to collective health and also to public funds (12) . As the most consistent bedside care providers, nurses have an ideal position to improve antibiotic management through multidisciplinary collaboration, optimizing treatment, monitoring and administration, while improving pediatric patient safety and quality of care (11) . The lack of parenteral drugs in adequate presentation for pediatrics represents a worldwide problem, constituting one of the factors that most contributes to the reuse of these medicines and also to increased care costs (13)(14) .…”

‘Esprit de corps’: Towards collaborative integration of pharmacists and nurses into antimicrobial stewardship programmes in South Africa

“…insulin, and ensuring timely and correct administration of antimicrobials. [7] A study conducted in 33 Netcare hospitals found that pharmacists and nurses can collectively improve the timeous administration of antibiotics. [8] Among other things, the study involved institutional system changes and the creation of awareness of administration priority, changing perceptions on waiting times for fixed dosing schedules, and adding commonly prescribed antibiotics to ward stock to prevent delays in administration.…”