Staff nurses' antimicrobial stewardship practices and performance confidence relative to patient safety culture

Current antimicrobial stewardship guidelines from the Centers for Disease Control and Prevention (CDC) suggest staff nurses play a key role in the stewardship process. The American Nurses Association (ANA) supports the CDC guideline and has charged nursing leaders with allotting organizational resources and aligning their workplace culture to support nurses' role. Despite national attention on nurses' involvement in antimicrobial stewardship, there is neither research describing practices used by nurses that impact antimicrobial stewardship processes; nor, is there understanding about how organizations' patient safety culture influences nurses' role in stewardship. Therefore, the purpose of this dissertation study is to determine pediatric and adult staff nurses' understanding of current practices that support antimicrobial stewardship, nurses' confidence to perform stewardship practices, and the influence of organizational patient safety culture on practices.Includes bibliographical reference

A novel framework to guide antibiotic stewardship nursing practice.

BACKGROUND: There is a pervasive view among some nurses and health care disciplines that antibiotic stewardship (AS) is solely a physician or pharmacist responsibility. There is an urgent need to alter this view so that nurses can seize every opportunity to prevent patient harm from antibiotics and optimize antibiotic use. One challenge to achieving full nurse engagement as equal members of the AS team is lack of an organizing framework to illustrate relationships of phenomena and concepts inherent to adoption of AS nursing practices. METHODS: We sought to create a framework derived from the peer-reviewed literature, systematic and scoping reviews, and professional standards, consensus statements and white papers. The emerging framework went through multiple iterations as it was vetted with nurse clinicians, scholars and educators, physicians, pharmacists, infection preventionists and AS subject matter experts. RESULTS: Our evidence-based Antibiotic Stewardship Nursing Practice SCAN-P Framework provides the much-needed context and clarity to help guide local-level nurses to participate in and lead AS nursing practice. CONCLUSIONS: Nurses worldwide are ideally situated to provide holistic person-centered care, advocate for judicious use of antibiotics to minimize antibiotic resistance, and be AS educators of their patients, communities and the general public. The Antibiotic Stewardship Nursing Practice SCAN-P Framework provides a tool to do so

Policies and practices of SHEA Research Network hospitals during the COVID-19 pandemic

To understand hospital policies and practices as the COVID-19 pandemic accelerated, the Society for Healthcare Epidemiology of America (SHEA) conducted a survey through the SHEA Research Network (SRN). The survey assessed policies and practices around the optimization of personal protection equipment (PPE), testing, healthcare personnel policies, visitors of COVID-19 patients in relation to procedures, and types of patients. Overall, 69 individual healthcare facilities responded in the United States and internationally, for a 73% response rate

Improving antimicrobial use through better diagnosis: The relationship between diagnostic stewardship and antimicrobial stewardship

Antimicrobial stewardship programs (ASPs) exist to optimize antibiotic use, reduce selection for antimicrobial-resistant microorganisms, and improve patient outcomes. Rapid and accurate diagnosis is essential to optimal antibiotic use. Because diagnostic testing plays a significant role in diagnosing patients, it has one of the strongest influences on clinician antibiotic prescribing behaviors. Diagnostic stewardship, consequently, has emerged to improve clinician diagnostic testing and test result interpretation. Antimicrobial stewardship and diagnostic stewardship share common goals and are synergistic when used together. Although ASP requires a relationship with clinicians and focuses on person-to-person communication, diagnostic stewardship centers on a relationship with the laboratory and hardwiring testing changes into laboratory processes and the electronic health record. Here, we discuss how diagnostic stewardship can optimize the Four Moments of Antibiotic Decision Making created by the Agency for Healthcare Research and Quality and work synergistically with ASPs