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Integrating bedside nurses into antibiotic stewardship: A practical approach.

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Nurses can enhance antibiotic stewardship (AS) by improving diagnostic testing and documentation. Integrating nurses into AS programs requires addressing barriers through education and improved workflows for better patient safety.

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Area of Science:

  • Healthcare quality improvement
  • Infectious disease management
  • Nursing practice

Background:

  • Nurses play a crucial role in patient safety and express interest in antibiotic stewardship (AS).
  • Despite daily involvement in antibiotic-sensitive clinical activities, AS functions are not formally integrated into nursing practice.
  • National recommendations support expanding AS programs to include nurses, but practical guidance is lacking.

Purpose of the Study:

  • To provide a framework for integrating nurses into antibiotic stewardship (AS) activities.
  • To identify specific nursing practices that can improve antibiotic prescribing.
  • To address barriers to nurse engagement in AS and propose solutions.

Main Methods:

  • Review of selected nursing practices impacting antibiotic prescribing.
  • Identification of barriers to nurse participation in AS.
  • Proposal of solutions using patient safety and quality improvement principles.

Main Results:

  • Nurses can improve antibiotic prescribing through appropriate C. difficile testing, urine culturing, antibiotic administration, penicillin allergy documentation, and prompting antibiotic time-outs.
  • Key barriers to nurse engagement in AS were identified.
  • Potential solutions involving education, communication, and workflow integration were proposed.

Conclusions:

  • Integrating nurses into antibiotic stewardship programs is feasible and beneficial for patient safety.
  • Addressing identified barriers through targeted strategies can enhance nurse participation in AS.
  • This review offers a framework to support nurses as integral partners in antibiotic stewardship efforts.