Nurses have been overlooked in antimicrobial stewardship programs, study finds

Empowering nurses to participate in antimicrobial stewardship programs (ASPs) is the missing link in strengthening hospital-wide antimicrobial stewardship and improving patient care, according to a new study presented  at the 45th Annual Conference of the Association for Professionals in Infection Control and Epidemiology (APIC).

The research, conducted at Jefferson Health in New Jersey, shows that ASPs are strengthened by educating nurses about antimicrobial stewardship and obtaining their buy-in.

"Our findings show that nurses have been overlooked and under-utilized in ASPs," said Jefferson Health - New Jersey Infection Control Officer Cindy Hou, DO, MA, MBA, FACOI, the study's lead author. "Changing the culture and empowering nurses to speak up about antimicrobial stewardship leads to closer team coordination and cross-discipline collaboration, which ultimately saves lives."

A 10-question quiz on antibiotic usage found that nurses were generally not comfortable with microbiology reports or familiar with the unique features of different antibiotics. A baseline assessment found that 93.8 percent of nurses incorporated microbiology results during sign-out reporting, but only 50 percent checked susceptibility results of cultures before administering antibiotics. What's more, only 65.1 percent of clinical nurses notified physicians if cultures showed resistance.

Nurse buy-in was achieved by engaging chief nursing officers at Jefferson's three New Jersey hospitals, opening up participation in ASPs to nursing leadership, educators, performance improvement, and infection control staff.

Materials were written in "nurse speak" and integrated into the typical nursing work flow to promote usage.

"Multidrug-resistant organisms cause a significant proportion of serious healthcare-associated infections and are more difficult to treat because there are fewer and, in some cases, no antibiotics that will cure the infection," said 2018 APIC President Janet Haas, PhD, RN, CIC, FSHEA, FAPIC. "This study shows that by engaging with nurses and pushing for greater team collaboration, major progress can be made on ASPs, which is essential to help reduce the threat of antibiotic resistance."