Nurses are the missing link in antimicrobial stewardship plans

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Nurses have been “overlooked and under-used” in hospital antimicrobial stewardship programmes (ASPs), according to US researchers. A study, conducted at a facility run by Jefferson Health in New Jersey, suggested that ASPs were strengthened by educating nurses about antimicrobial stewardship and obtaining their “buy-in”.

The research was presented this week at the Association for Professionals in Infection Control and Epidemiology’s annual conference in Minneapolis.

A 10-question quiz on antibiotic usage found that nurses were generally not comfortable with microbiology reports or familiar with the unique features of different antibiotics.

A baseline assessment found that 93.8% of nurses incorporated microbiology results during sign-out reporting, but only 50% checked susceptibility results of cultures before administering antibiotics. In addition, only 65.1% of clinical nurses notified doctors if cultures showed resistance, said the researchers.


"By engaging with nurses and pushing for greater team collaboration, major progress can be made on ASPs"


Better nurse “buy-in” was achieved by engaging chief nurses at the provider’s three New Jersey hospitals. It was also achieved by opening up participation in ASPs to nurse leaders, educators, performance improvement, and infection control staff. Meanwhile, materials were written in “nurse speak” and integrated into the typical nursing work flow to promote usage, according to the researchers.

Lead study author Cindy Hou, an infection control officer at Jefferson Health, said “our findings show that nurses have been overlooked and under-utilised in ASPs. Changing the culture and empowering nurses to speak up about antimicrobial stewardship leads to closer team co-ordination and cross-discipline collaboration, which ultimately saves lives.”

APIC president and nurse Janet Haas said “multi-drug resistant organisms cause a significant proportion of serious healthcare-associated infections and are more difficult to treat because there are fewer and, in some cases, no antibiotics that will cure the infection. This study shows that by engaging with nurses and pushing for greater team collaboration, major progress can be made on ASPs, which is essential to help reduce the threat of antibiotic resistance.”

Explore CKN Antimicrobial Stewardship Resources

CKN journal articles and resources such as BMJ Best PracticeClinicalKey for NursingNursing Reference Center Plus and DynaMed Plus provide a wealth of information about antimicrobial stewardship.

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