Janine Carrucan 1
1 Nursing Director, Infection Prevention & Control, Townsville Hospital & Health Service, Douglas, QLD, Australia
A typical multidisciplinary Antimicrobial Stewardship (AMS) program utilises the expertise and resources of Infectious Disease physicians, Clinical Microbiologists, and Pharmacists. Success relies on executive support, adequate resources and the engagement of prescribers.
Where do nurses fit in?
Nurses are the most consistent providers of direct care at the bedside. They are an information source for patients and families, have good organisational skills, are used to working in a multidisciplinary environment, and have a close working relationship with clinicians. Nurses administer prescribed antibiotics, identify prescribing errors, and detect adverse effects from medications.
It is obvious that nurses are in an ideal position to be involved in AMS.
In 2013, an AMS program was initiated at a north Queensland tertiary referral hospital, and a clinical nurse was employed to join the pharmacist and physicians in the AMS team. At the outset, the need for nursing involvement had been recognised; however, the role was largely undefined and the scope of practice needed to be identified.
Numerous activities were identified and enacted during the planning and implementation phase of the AMS program. These include improving antimicrobial administration; facilitating rapid delivery in emergency situations; helping with therapeutic drug monitoring and IV-to-oral switch; improving techniques for obtaining good specimen collection for culture and diagnosis; assessing patient response to therapy; education and auditing.
AMS requires a multidisciplinary response in order to provide the best care for patients, and nurses have an indispensable role in AMS provision.