Registered nurses' antimicrobial stewardship roles: a qualitative descriptive exploratory study

Introduction Antimicrobial stewardship (AMS) is a global initiative aimed at promoting the responsible use of antimicrobials to combat antimicrobial resistance (AMR), a critical global health threat. In New Zealand, over 95% of antibiotics are prescribed in the community, with estimates suggesting that half of these prescriptions are for self-limiting respiratory infections, contributing significantly to AMR. Registered nurses (RNs), especially nurse practitioners and designated nurse prescribers, are well-positioned to play a pivotal role in AMS efforts due to their accessibility and broad skill set. However, their potential remains underutilised in AMS programmes. Aim This study aimed to explore the role of New Zealand Māori and non-Māori registered nurses as antimicrobial stewards within the New Zealand health care system. Methods The current knowledge and involvement in activities that mitigate the risks of infectious diseases and AMR of registered nurses was assessed. The educational and organisational support needed to enhance their leadership and engagement in AMS initiatives were identified. Results Findings highlight the need for targeted AMS education, greater participation in stewardship activities, and clarity in RN roles in collaboration with other health care professionals. This research underscores the importance of empowering registered nurses through education and organisational support to strengthen AMS and mitigate the growing threat of AMR. Discussion This study provides key insights into the leadership potential of RNs in AMS and offers recommendations for future policy and education strategies to optimise their role in New Zealand's health care.