Background:Medication prescription is generally the responsibility of doctors. In nursing homes, the nursing staff is often the first to suspect an infection. Today, physicians are more confident with nursing assessment, relying primarily on nursing staff information. Very few studies have investigated the nurses’ influence on decision of medical prescription. This study investigates the role of nurses in antibiotic prescribing for the treatment of suspected infections in nursing home residents.Design and methods:An ethnographic study based on semi-structured interviews and participant observations was conducted. Sixteen nurses and five doctors working in five nursing homes in Paris, France participated between October 2015 and January 2016.Results:Given their proximity to elderly residents, registered nurses at the nursing homes occasionally assisted doctors in their medical diagnostic. However, nurses who are theoretically incompetent have met difficulties in their ability to participate in their decisions to prescribe antibiotics when managing residents’ infections.Conclusion: if proximity and nursing skills reinforce the relevance of the clinical judgment of nurses, the effective and collaborative communication between the nurse and the doctor may help the nurse to enhance their role in the antibiotic prescribing in nursing homes, which would enhance antimicrobial stewardship efficiency.Significance for public healthThe study described in this paper is significant for the field of public health for several reasons. The consumption of antibiotics is a serious worldwide problem. Before implementing an antibiotic stewardship in NH, we needed to better know how antibiotic were prescribed. The knowledge from this study should be used in practice to optimize the role of nurses in reducing inappropriate prescribing of antibiotics. The efficient interaction of nurses during the decision-making process of the antibiotic prescribing produce an appropriate care in NH, which would be contributed to decrease the microbial resistance and therefore the cost of health services.

Aim: To identify and describe the role of non-prescribing nurses in medical prescription, through a critical synthesis of all the studies published worldwide answering this question. Background: Medical prescription is a prerogative of the physician. Yet, the final decision for prescribing is most often the conjunction of different factors and actors. What could be the role of non-prescribing nurses in medical prescription? Design: A systematic literature review. Methods: A literature search of the databases, the Ovid MEDLINE database, PubMed, Web of Science, Cochrane, and Cumulative Index to Nursing and Allied Health Literature (CINAHL), was done to identify studies that describe the nurse's role in medical prescription up to May 2017. A quality assessment of relevant studies was performed. Results: Four studies were included in this review. The overall methodological quality of the studies was intermediate (score: 8.5 of 12). Analyses of the included articles show the nurses have an essential role in the administration of medications and in the follow-up of the drug consequences. In addition, nurses tend to share the decision regarding prescribing with the doctors through an inter-professional collaborative approach. Nurses do not have sufficient knowledge about pharmacology and drug management. Conclusions: Our systematic review emphasizes the importance of multidisciplinary collaboration between nurses and other health professionals in acute care settings. The strong involvement of nurses could provide a dialogue to strengthen best practice. Improving the nurses' knowledge and their skills are likely to enhance the optimization of treatment. Relevance to Clinical Practice: The current literature suggests a refinement of pharmacological knowledge among nurses and effective nurse-doctor interactions to guide the best medical prescribing.

Background Nurses face multiple stressors that can influence their lifestyle, thus affecting their health status. Scarce are the scientific data on the nutritional status of nurses, especially during health crises. The aim of this study was to assess the impact of the COVID-19 pandemic on the eating habits of hospital nurses in the context of an exceptional economic situation in Lebanon. Methods A cross-sectional study was conducted using a web-based questionnaire, targeting a non-random sampling of frontline nurses using the snowball technique. Descriptive and bivariate analyses were carried out. The population of the study included all registered nurses working in the Lebanese hospitals. A total of 533 nurses completed the questionnaire; 500 surveys were selected after excluding the ones presenting conditions that may affect their eating behavior. Results The majority of the respondents were women (78.6%) with a mean age of 33 years [18-60] [SD,7.44 years]. Most of them (57.6%) had a crowding index ≥1. The consumption of different food groups decreased during these crises. There was a significant correlation between stress and deterioration of healthy food consumption, which provides beneficial nutrients and minimizes potentially harmful elements, especially for meat (OR 2.388, CI 1.463 to 3.898, P < 0.001). The decrease in monthly income showed a real impact on the consumption of healthy food such as meat (OR 2.181, CI 1.504 to 3.161, P < 001), fruits (OR 1.930, CI 1.289 to 2.888, P = 0.001), and milk and dairy products (OR 1.544, CI 1.039 to 2.295, P = 0.031). Conclusions The pandemic and in particular the economic crisis has changed the consumption of healthy food among hospital nurses in Lebanon. Similar research and support may be extended to include other frontline health care workers.