Antimicrobial stewardship: Staff nurse knowledge and attitudes

Merrill, Katreena Collette; Hanson, Sandra F.; Sumner, Sharon; Vento, Todd J.; Veillette, John J.; Webb, Brandono

doi:10.1016/j.ajic.2019.03.022

Cited by 31 publications

(37 citation statements)

References 17 publications

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“…For the respondents' physicians and pharmacists, the self-administered questionnaire was adapted from previous studies with similar objectives [14,15]. Another questionnaire designed in the Arabic language and referenced from previous studies with similar objectives was designed for nurses [5,16].…”

Section: The Study Questionnaires Establishmentmentioning

confidence: 99%

“…The US Centers for Disease Control and Prevention (CDC) is undertaking a nationwide effort to appropriately improve antimicrobials use in healthcare settings [4]. As a result, the CDC and others recommend the implementation of antimicrobial stewardship (AMS) programs [5]. AMS programs are a set of multidisciplinary interventions that aim to ensure the rational use of antimicrobials by preventing their unnecessary use and to provide targeted and limited therapy in conditions where they are necessary [6].…”

Section: Introductionmentioning

confidence: 99%

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The effect of educational intervention on healthcare providers’ knowledge, attitude, & practice towards antimicrobial stewardship program at, National Liver Institute, Egypt

Tahoon

Khalil

Hammad

et al. 2020

Egypt Liver Journal

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Background: Inappropriate use of antimicrobials results in rapid emergence of resistance, selection pressure on resistant microorganisms, adverse reactions, and treatment failures. An effective approach to improving antimicrobial use in healthcare settings is a structured antimicrobial management program known as antimicrobial stewardship (AMS). Education and training is considered a backbone element of AMS program .This study aimed to evaluate the impact of educational program on the knowledge, attitude, and practice (KAP) of healthcare providers (HCPs) towards antimicrobial stewardship before and after the educational program at the surgery department and surgical ICU, National Liver Institute hospital (NLI), Egypt.Results: Among the 69 invited HCPs, 48 attended the educational program sessions with attendance response rate about 70%. Regarding pre-educational KAP score of the respondents' physicians and pharmacists, 39.3% of them had good knowledge score, 85.7% of them had positive attitude, &and 31.8% of physicians had good practice score; however, 100% of the pharmacists had poor practice. Regarding the respondents' nurse, the pre-education mean score of knowledge was 13.3/20, attitude 14.8/16, and practice 9.3/14. Following educational program, there was a significant improvement in knowledge, attitude, and practice of the respondents' health care providers (P < 0.001); on the contrary, there was no significant improvement in the practice of pharmacists (P > 0.05). Conclusion:The implemented educational program was successful in improving the knowledge, attitude, and practice of HCPs; therefore, continuous efforts are needed to implement more educational programs to increase awareness towards AMS among HCPs.

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Section: The Study Questionnaires Establishmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effect of educational intervention on healthcare providers’ knowledge, attitude, & practice towards antimicrobial stewardship program at, National Liver Institute, Egypt

Tahoon

Khalil

Hammad

et al. 2020

Egypt Liver Journal

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“…88 Nurses' engagement with antimicrobial stewardship Three studies identified that many nurses were unaware of the term AMS, however, they knew that they had a role in ensuring appropriate and safe antibiotic therapy for patients. 9,11,57 Merrill et al 89 reported similar results in adult settings, where half of the nurses were not aware of AMS, however, almost all participants believed that nurses should be involved in AMS interventions. A lack of education was further highlighted in Kilpatrick et al 11 which identified a practice to theory gap whereby nurses were implementing AMS principles in their practice but were unaware of the terminology.…”

Section: The Role Of Consumers In Ipcmentioning

confidence: 80%

Paediatric nurses’, children's and parents’ adherence to infection prevention and control and knowledge of antimicrobial stewardship: A systematic review

Kilpatrick

Hutchinson

Manias

et al. 2021

American Journal of Infection Control

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Introduction: Infection prevention and control precautions help to decrease microbial transmission, and through the appropriate use of antibiotics, Antimicrobial Stewardship programs aim to decrease the prevalence and emergence of Antimicrobial Resistance. Methods: A systematic review was undertaken to critically appraise and synthesise evidence for nurses', children's and parents' knowledge and understanding of antimicrobial stewardship, and of infection prevention and control in acute paediatric care settings. The Preferred Reporting Items for Systematic reviews and Meta-Analyses guided the review. Studies were included if they examined the factors that contributed to nurses' adherence to, or consumers' practice in relation to, antimicrobial stewardship and infection prevention and control. Results: Of the 16,957 papers identified, 50 studies conducted in acute paediatric settings met the eligibility criteria, and were included. Most studies were of low methodological quality. Fourteen studies evaluated nurses' knowledge and self-reported adherence to Infection Prevention and Control principles and identified consistent practice gaps by nurses. Six studies evaluating the effectiveness of education programs reported modest improvements in nurses' knowledge and adherence to infection prevention and control. There were 15 studies, that investigated consumers' involvement in infection prevention and control that identified the following themes: Consumer knowledge and attitudes to infection prevention and control and transmissionbased precautions, and parents' willingness to take an active role in infection prevention. Six studies focused on paediatric nurses' role in antimicrobial stewardship, exploring the following themes: (1) nurses' understanding and beliefs of antimicrobial stewardship roles, and (2) barriers to nurses taking a greater role in antimicrobial stewardship. Nine studies explored the role of consumers in antimicrobial stewardship and identified consumers' misconceptions about the benefits and downplayed concerns regarding antibiotic use. Discussion: Although consumers articulated a willingness to be actively involved in infection prevention, observed practice remained lower than that required to consistently prevent infection transmission. Conclusion: These findings highlight a critically important gap in current practice. In relation to optimal use of antimicrobials, although paediatric nurses were involved in supporting antimicrobial stewardship processes and educating consumers, they identified limited antimicrobial stewardship knowledge. Consumers appeared to lack understanding about the benefits of antibiotics and negated concerns regarding antibiotic use.

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“…However, a recent study of 316 nurses from 3 hospitals found that while 95% believed in antibiotic stewardship interventions, 52% were not familiar with the term "antibiotic stewardship" and only 39.6% indicated that antibiotic stewardship programs were moderately or extremely important in their health care setting. 42 Promoting antibiotic stewardship education for nurses, in both content and communication, would be a key step toward more appropriate antibiotic usage in EDs and LTCFs.…”

Section: Discussionmentioning

confidence: 99%

The impact of health care provider relationships and communication dynamics on urinary tract infection management and antibiotic utilization for long-term care facility residents treated in the emergency department: A qualitative study

Valmadrid

Schwei

Maginot

et al. 2021

American Journal of Infection Control

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Background: For older adults, over diagnosis of urinary tract infections (UTI) is a primary driver of inappropriate antibiotic use. This risk is increased for patients in long-term care facilities (LTCF), especially as they transition back and forth to emergency departments (ED). In this study, we aimed to understand how health care provider communication and relationship dynamics affect LTCF residents treated in the ED to identify barriers to antibiotic stewardship for UTIs. Methods: We conducted semi-structured interviews with nurses and physicians from LTCFs and EDs, guided by the Systems Engineering Initiative for Patient Safety framework. Data were systematically coded and underwent iterative, conventional, content analysis. Results: We interviewed 16 LTCF and 16 ED providers across Wisconsin. ED and LTCF nurses have a critical role in both intrafacility and interfacility communication. Fragmented communication and interprofessional power dynamics were identified barriers to optimal antibiotic prescribing for UTIs. Identified strategies to overcome these issues included using objective diagnostic criteria, development of communication scripts, and nurse-to-nurse education. Conclusions: Our qualitative approach revealed important insights about how communication and relationship dynamics influence UTI diagnosis and optimal antibiotic stewardship for LTCF residents evaluated in the ED. Future interventions should strengthen communications between settings and across provider types, and address standardization of diagnostic and treatment communication pathways for LTCF residents with suspected infections transitioning between EDs and LTCFs.

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Antimicrobial stewardship: Staff nurse knowledge and attitudes

Cited by 31 publications

References 17 publications

The effect of educational intervention on healthcare providers’ knowledge, attitude, & practice towards antimicrobial stewardship program at, National Liver Institute, Egypt

The effect of educational intervention on healthcare providers’ knowledge, attitude, & practice towards antimicrobial stewardship program at, National Liver Institute, Egypt

Paediatric nurses’, children's and parents’ adherence to infection prevention and control and knowledge of antimicrobial stewardship: A systematic review

The impact of health care provider relationships and communication dynamics on urinary tract infection management and antibiotic utilization for long-term care facility residents treated in the emergency department: A qualitative study

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