The role of the intensive care nurse in antimicrobial stewardship

systematic review

Authors

DOI:

https://doi.org/10.48492/servir0208.33029

Keywords:

nurse, intensive care unit, antimicrobial stewardship, nurse’s role

Abstract

Introduction: Nowadays there has been a rise in the incidence of antimicrobial-resistant microorganisms. It’s important to involve every member of the interdisciplinary team in the investment of strategies that promote an adequate use of antimicrobials, particularly in the critically ill patient.

Objective: To determine the role of the intensive care nurse in antimicrobial stewardship.

Methods: A systematic review of the literature was conducted on the EBSCO Discovery Service platform and the Scopus and SciELO databases, using health science descriptors and key words. The research question was developed using the PICO strategy and the articles were selected by two independent reviewers using the PRISMA methodology.

Results: 9 articles were selected and analyzed. 7 categories emerged: review of the antimicrobial prescription; collection of samples with critical thinking; monitoring the critically ill and administration of antimicrobials; identification of allergies; implement infection control precautions; health education; and leadership and communication.

Conclusion: The nurses that work in intensive care units implement interventions that promote an adequate use of antimicrobials. However, in order to better define their role and improve their involvement in the multidisciplinary team, there is a need to conduct more studies

Downloads

Download data is not yet available.

References

American Nurses Association, Centers for Disease Control and Prevention (2017). Redefining the antibiotic stewardship team: Recommendations from the American Nurses Association/Centers for Disease Control and Prevention workgroup on the role of registered nurses in hospital antibiotic stewardship practices. https://www.cdc.gov/antibiotic-use/healthcare/pdfs/ana-cdc-whitepaper.pdf

Aromataris E, & Munn Z. JBI Manual for Evidence Synthesis. JBI. https://doi.org/10.46658/JBIMES-20-02

Blot, S., Ruppé, E., Harbarth, S., Asehnoune, K., Poulakou, G., Luyt, C. E., ... Zahar, J. R. (2022). Healthcare-associated infections in adult intensive care unit patients: Changes in epidemiology, diagnosis, prevention and contributions of new technologies. Intensive and Critical Care Nursing, 70. https://doi.org/10.1016/j.iccn.2022.103227

Bolla, B., Buxani, Y., Wong, R., Jones, L., & Dube, M. (2020). Understanding IV antimicrobial drug losses: the importance of flushing infusion administration sets. JAC - Antimicrobial Resistance, 2(3). https://doi.org/10.1093/jacamr/dlaa061

Branco, M. J. C., Lucas, A. P. M., Marques, R. M. D., & Sousa, P. P. (2020). The role of the nurse in caring for the critical patient with sepsis. Revista Brasileira de Enfermagem, 73(4). https://doi.org/10.1590/0034-7167-2019-0031

Carter, E. J., Greendyke, W. G., Furuya, E. Y., Srinivasan, A., Shelley, A. N., Bothra, A., … Larson, E. L. (2018). Exploring the nurses’ role in antibiotic stewardship: A multisite qualitative study of nurses and infection preventionists. American Journal of Infection Control, 46(5), 492–497. https://doi.org/10.1016/j.ajic.2017.12.016

Centers for Disease Control and Prevention. (2019). The core elements of hospital antimicrobial stewardship programs: 2019. https://www.cdc.gov/antibiotic-use/healthcare/pdfs/hospital-core-elements-H.pdf

Felix, A. M. S., Jarina, N. V., Perinoti, L. C. S. C., Couto, D. S., Paz, B. R., & Figueiredo, R. M. (2022). Práticas autorreferidas de enfermeiros sobre gerenciamento de antimicrobianos. Revista de Enfermagem e Atenção à Saúde, 11(2). https://doi.org/10.18554/reas.v11i2.6059

Lenz, A., Davis, G., Asmar, H., Nahapetian, A., Dingilian, J., & Nathan, R. v. (2021). Using a nurse-initiated bedside tool to decrease inappropriate testing for Clostridioides difficile in hospital settings. Journal of Infection Prevention, 22(3), 136–139. https://doi.org/10.1177/1757177420976815

Mabilat, C., Gros, M. F., van Belkum, A., Trubiano, J. A., Blumenthal, K. G., Romano, A., & Timbrook, T. T. (2022). Improving antimicrobial stewardship with penicillin allergy testing: a review of current practices and unmet needs. JAC-Antimicrobial Resistance, 4(6). https://doi.org/10.1093/jacamr/dlac116

Manning, M. L. & Pogorzelska-Maziarz, M. (2018). Health care system leaders’ perspectives on infection preventionist and registered nurse engagement in antibiotic stewardship. American Journal of Infection Control, 46(5), 498–502. https://doi.org/10.1016/j.ajic.2017.10.024

Monsees, E. A., Tamma, P. D., Cosgrove, S. E., Miller, M. A., & Fabre, V. (2019). Integrating bedside nurses into antibiotic stewardship: A practical approach. In Infection Control and Hospital Epidemiology, 40 (5), 579–584. Cambridge University Press. https://doi.org/10.1017/ice.2018.362 15 de 16

Olans, R. N., Olans, R. D., & Demaria, A. (2016). The critical role of the staff nurse in antimicrobial stewardship - Unrecognized, but already there. Clinical Infectious Diseases, 62(1), 84–89. https://doi.org/10.1093/cid/civ697

Padigos, J., Reid, S., Kirby, E., Anstey, C., & Broom, J. (2022). Nursing experiences in antimicrobial optimisation in the intensive care unit: A convergent analysis of a national survey. Australian Critical Care, 36(5), 768-781. https://doi.org/10.1016/j.aucc.2022.09.005

Póvoa, P., Moniz, P., Pereira, J. G., & Coelho, L. (2021). Optimizing antimicrobial drug dosing in critically ill patients. In Microorganisms, 9(7). MDPI AG. https://doi.org/10.3390/microorganisms9071401

Raybardhan, S., Kan, T., Chung, B., Ferreira, D., Bitton, M., Shin, P., & Das, P. (2020). Nurse prompting for prescriber-led review of antimicrobial use in the critical care unit. American Journal of Critical Care, 29(1), 71–76. https://doi.org/10.4037/ajcc2020272

Schmid, S., Schlosser, S., Gülow, K., Pavel, V., Müller, M., & Kratzer, A. (2022). Interprofessional collaboration between ICU physicians, staff Nurses, and hospital pharmacists optimizes antimicrobial treatment and improves quality of care and economic outcome. Antibiotics, 11(3). https://doi.org/10.3390/antibiotics11030381

Schnock, K. O., Ravindran, S. S., Fladger, A., Leone, K., Williams, D. M., Dwyer, C. L., … Gazarian, P. (2017). Identifying information resources for patients in the intensive care unit and their families. Critical Care Nurse, 37(6), e10–e16. https://doi.org/10.4037/ccn2017961

Uddin, T. M., Chakraborty, A. J., Khusro, A., Zidan, B. R. M., Mitra, S., Emran, … Koirala, N. (2021). Antibiotic resistance in microbes: History, mechanisms, therapeutic strategies and future prospects. In Journal of Infection and Public Health, 14 (12), 1750–1766. https://doi.org/10.1016/j.jiph.2021.10.020

World Health Organization. (2015). Global Action plan on antimicrobial resistance. https://www.amcra.be/swfiles/files/WHO%20actieplan_90.pdf

World Health Organization. (2021). Antimicrobial stewardship interventions: A practical guide. World Health Organization Regional Office for Europe. https://apps.who.int/iris/bitstream/handle/10665/340709/9789289054980-eng. pdf?sequence=1&isAllowed=y

van Gulik, N., Hutchinson, A., Considine, J., Driscoll, A., Malathum, K., & Botti, M. (2021). Perceived roles and barriers to nurses’ engagement in antimicrobial stewardship: A Thai qualitative case study. Infection, Disease and Health, 26(3), 218–227. https://doi.org/10.1016/j.idh.2021.04.003

van Huizen, P., Kuhn, L., Russo, P. L., & Connell, C. J. (2021). The nurses’ role in antimicrobial stewardship: A scoping review. International Journal of Nursing Studies, 113. https://doi.org/10.1016/j.ijnurstu.2020.103772

Verma, M., Shafiq, N., Tripathy, J. P., Nagaraja, S. B., Kathirvel, S., Chouhan, D. K., … Dhillon, M. S. (2019). Antimicrobial stewardship programme in a trauma centre of a tertiary care hospital in North India: Effects and implementation challenges. Journal of Global Antimicrobial Resistance, 17, 283–290. https://doi.org/10.1016/j.jgar.2019.02.020

Vincent, J.L., Sakr, Y., Singer, M., Martin-Loeches, I., Machado, F. R., Marshall, J. C., … Angus, D. C. (2020). Prevalence and outcomes of infection among patients in intensive care units in 2017. The Journal of the American Medical Association, 323(15), 1478-1487. https://doi:10.1001/jama.2020.2717

Published

2024-05-17

How to Cite

Brandão, M., & Coelho, P. . (2024). The role of the intensive care nurse in antimicrobial stewardship: systematic review. Servir, 2(08), e33029. https://doi.org/10.48492/servir0208.33029