Nurses' knowledge and implementation of antimicrobial stewardship and infection prevention strategies in acute paediatric settings

J Hosp Infect. 2023 Jul:137:54-60. doi: 10.1016/j.jhin.2023.05.001. Epub 2023 May 7.

Abstract

Background: Nurses are the first point of contact for patients and are responsible for monitoring and reporting signs of infection. The COVID-19 pandemic cemented nurses' leadership role in infection prevention. Despite this, nurses' contribution to antimicrobial stewardship initiatives remains under-recognized.

Aim: To determine how paediatric nurses understood their role and contribution to antimicrobial stewardship and infection prevention and control practices in three different acute paediatric wards.

Methods: Forty-three nurses were recruited from an adolescent ward, an oncology ward, and a surgical ward in a metropolitan tertiary children's hospital for a qualitative exploratory descriptive study.

Findings: Thematic and content analysis derived three themes from the data: understanding of preventable infections; embracing evidence-based guidelines to protect the patient; and roles in preventing and controlling infections and antimicrobial stewardship. Associated subthemes were: desensitized to COVID-19; understanding infection prevention and control precautions; correct use of hospital policy and guidelines; restrictions associated with the use of electronic medical records; understanding of sepsis management and the importance of timely microbiological testing; ambivalence on antimicrobial stewardship roles; and high priority placed on consumer education.

Conclusion: Nurses' understanding of their role focused on practices such as performing hand hygiene, standard precautions, and reporting the use of high-risk antimicrobials. A lack of understanding of paediatric COVID-19 transmission and presentations was also reported. Education on best practice in infection prevention and AMS was recognized as crucial for both nurses and parents.

Keywords: Infection prevention and control; Nursing; Paediatrics; Patient education; Patient participation.

MeSH terms

  • Adolescent
  • Antimicrobial Stewardship*
  • COVID-19* / prevention & control
  • Child
  • Clinical Competence
  • Humans
  • Pandemics / prevention & control
  • Qualitative Research