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Posted: February 4th, 2024

Exploring the Role of Nurses in Antimicrobial Stewardship Programme in Reducing Antibiotics

Exploring the Role of Nurses in Antimicrobial Stewardship Programme in Reducing Antibiotics Misuse and Antimicrobial Resistance

Antimicrobial resistance (AMR) is a global public health threat that is exacerbated by the overuse and inappropriate prescribing of antimicrobials, such as antibiotics. AMR can lead to infections that are difficult to treat, increased mortality rates, and higher healthcare costs. Antimicrobial stewardship (AMS) is an organisational or healthcare-system-wide approach to promoting and monitoring judicious use of antimicrobials to preserve their future effectiveness. Nurses, as the largest group of healthcare professionals, play a vital role in AMS by influencing prescribing decisions, educating patients and the public, and implementing infection prevention and control measures.

This blog post aims to explore the role of nurses in AMS programmes in reducing antibiotics misuse and AMR, based on the latest evidence and best practice guidelines. It will also discuss the challenges and opportunities for nurses to engage in AMS activities and suggest some recommendations for improving their knowledge, skills, and involvement in this area.

Nurses’ Role in AMS Programmes

Nurses are involved in various aspects of AMS programmes, such as:

– **Assessing patients’ infection status and risk factors**. Nurses are often the first point of contact for patients with suspected or confirmed infections. They can collect relevant clinical information, such as signs and symptoms, medical history, allergies, and comorbidities, and perform diagnostic tests, such as blood cultures, urine samples, or wound swabs. This can help to inform the diagnosis and guide the appropriate choice of antimicrobial therapy.

– **Administering antimicrobials**. Nurses are responsible for administering antimicrobials according to the prescribed regimen, which may include oral, intravenous, or topical routes. They can also monitor the patient’s response to treatment, such as clinical improvement, adverse effects, or drug interactions, and report any issues or concerns to the prescriber or pharmacist. Nurses can also ensure that antimicrobials are stored and disposed of properly to prevent contamination or misuse.

– **Reviewing antimicrobial therapy**. Nurses can participate in the review of antimicrobial therapy, which is a key component of AMS programmes. This involves evaluating the need for continuing, changing, or stopping antimicrobial therapy based on the patient’s clinical condition, microbiological results, or local resistance patterns. Nurses can also remind or prompt prescribers or pharmacists to conduct timely reviews and document their decisions and rationale.

– **Educating patients and the public**. Nurses can educate patients and their families about the appropriate use of antimicrobials, such as the importance of completing the course of treatment, not sharing or saving antibiotics for future use, and not requesting antibiotics for viral infections or minor ailments. They can also provide information about the potential side effects of antimicrobials and how to manage them. Moreover, nurses can raise awareness of AMR among the public through various channels, such as social media, campaigns, or community events.

– **Implementing infection prevention and control measures**. Nurses can implement infection prevention and control measures to reduce the transmission of infections and the need for antimicrobials. These include hand hygiene, personal protective equipment, isolation precautions, environmental cleaning, waste management, and vaccination.

Challenges and Opportunities for Nurses in AMS

Despite their crucial role in AMS programmes, nurses may face some challenges that limit their involvement or effectiveness in this area. These include:

– **Lack of knowledge and confidence**. Nurses may lack adequate knowledge or confidence in AMS principles or practices, such as how to assess infection status, how to interpret microbiological results, how to review antimicrobial therapy, or how to communicate with prescribers or pharmacists about AMS issues. This may be due to insufficient education or training opportunities, lack of feedback or support from senior colleagues, or lack of access to reliable sources of information or guidance.

– **Lack of recognition and empowerment**. Nurses may not be recognised or empowered as key players in AMS programmes by other healthcare professionals or managers. They may face barriers to influencing prescribing decisions, such as hierarchical structures, power dynamics, professional boundaries, or lack of interprofessional collaboration. They may also lack autonomy or authority to initiate or change antimicrobial therapy without consulting prescribers or pharmacists.

– **Lack of time and resources**. Nurses may not have enough time or resources to engage in AMS activities due to heavy workload, staff shortages, competing priorities, or administrative tasks. They may also lack access to essential equipment or facilities, such as computers, internet connection,


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