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Nurses as Antibiotic Brokers: Institutionalized Praxis in the Hospital
Alex Broom1, Jennifer Broom2, Emma Kirby1
11 The University of New South Wales, Sydney, Australia.
Qualitative Health Research
|December 3, 2016
Summary
Nurses play a critical role in managing antibiotic use, acting as essential brokers of physician decisions. Their influence challenges traditional views of prescribing power, highlighting their importance in combating antimicrobial resistance.
Area of Science:
- Healthcare Management
- Infectious Diseases
- Nursing Practice
Background:
- The world faces a post-antibiotic era due to rising antimicrobial resistance and overuse.
- Research on antibiotic use has primarily focused on physicians, neglecting the significant role of nurses.
Purpose of the Study:
- To explore nurses' roles in managing physician antibiotic decisions.
- To investigate nurses' capacity to challenge decisions and navigate organizational constraints.
- To highlight nurses as key stakeholders in antibiotic stewardship.
Main Methods:
- Qualitative study involving interviews with 30 nurses.
- Analysis of nurses' perspectives on their influence and strategies in antibiotic decision-making.
Main Results:
- Nurses act as crucial brokers of antibiotic decisions, influencing their implementation.
- Nurses possess the capacity to challenge physician orders and employ "backstage" strategies.
- Authority in antibiotic prescribing is often diffuse and mediated by institutional practices.
Conclusions:
- Nurses hold a non-neutral, essential position in hospital antibiotic use.
- Recognizing nurses' brokerage role is vital for effective antibiotic stewardship.
- Challenging the sole focus on physician prescribing power is necessary to leverage nurses' contributions to combatting antimicrobial resistance.
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