Nurses Want to Participate in Antimicrobial Stewardship Programs but Often Don’t Feel Welcome

Nurses think they should play a professional role in antimicrobial stewardship (AS) programs, but a culture of safety at hospitals that focuses on other kinds of providers often hinders nurse involvement. Investigators with Children’s Mercy Hospital in Kansas City, Missouri, and the University of Missouri in Columbia, Missouri, used a cross-sectional survey to gather data at 9 hospitals, ranging in size from 42 to 562 beds serving both pediatric and adult patients in 2 different metropolitan areas.

The study, in the American Journal of Infection Control, draws on data collected from 558 nurses and includes comments from 91 nurses with 50 statements saying that **the primary barrier to AS programs are organizational factors that included a perceived lack of a safety culture. **

When they were asked about what support they received to participate in AS programs, 43% and 27.3% of respondents said that they received encouragement from nursing leaders and physician prescribers respectively.

“Nurses identified the top engagement strategies as formal educational offerings, empowerment techniques to enhance communication, and soliciting nurse input in antibiotic use discussions,” the study states. “Whereas nurses expressed a desire to participate in stewardship processes, a lack of knowledge, safety culture, and poorly defined roles limited their ability to steward. Ninety percent of nurses reported at least one barrier to stewardship, although 95% perceived that they functioned as stewards.”