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Related Experiment Video

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Assessing antibiotic prescribing in nurse practitioners: Applied cognitive task analysis.

Nataly Martini1, Je Wei Choong1, Paula Donamae Dela Cruz1

  • 1School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.

International Journal of Nursing Studies Advances
|May 15, 2024
PubMed
Summary

New Nurse Practitioners (NPs) face complex cognitive challenges when prescribing antibiotics, including uncertainty and insufficient guidance. Understanding these cognitive demands can improve antibiotic stewardship and patient care.

Keywords:
Anti-bacterial agentsAntimicrobial StewardshipDrug prescriptionsInappropriate PrescribingNurse practitioners

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Area of Science:

  • Health Sciences
  • Medical Education
  • Pharmacology

Background:

  • Antibiotic prescribing is a complex decision-making process critical for minimizing antimicrobial resistance.
  • Little is known about the cognitive strategies new Nurse Practitioners (NPs) employ during antibiotic prescribing.

Purpose of the Study:

  • To identify the cognitive demands associated with complex antibiotic prescribing.
  • To explore the cognitive strategies utilized by new NPs in New Zealand when prescribing antibiotics.

Main Methods:

  • A qualitative approach using Applied Cognitive Task Analysis (ACTA) methodology.
  • In-depth interviews, including task diagram interviews and knowledge audits, were conducted with five recently registered NPs.
  • Data analysis followed the ACTA protocol.

Main Results:

  • Four key cognitive elements were identified, highlighting the complexities of antibiotic prescribing.
  • These elements include managing uncertainty, navigating insufficient guidance, individualizing treatment plans, and ensuring treatment efficacy and continuity of care.
  • Specific challenges involve complex patients, diagnostic uncertainty, lack of guidelines, patient expectations, and follow-up care.

Conclusions:

  • The Applied Cognitive Task Analysis (ACTA) framework provides insight into new NPs' antibiotic prescribing practices.
  • Findings can inform the development of targeted professional development and resources to support safe antibiotic prescribing.
  • Further research should explore the impact of educational resources and clinical pathways on diagnostic uncertainty in NP curricula.