ICU护士参与抗菌药物科学化管理现状及影响因素的质性研究

doi:10.3761/j.issn.2096-7446.2024.11.005

Abstract

Abstract: Objective To explore the current status and influencing factors of ICU nurses‘ participation in the antimicrobial stewardship to improve nurses‘ participation in the antimicrobial stewardship. Methods A semi-structured interview was conducted among ICU nurses in two districts of a tertiary class A hospital in Nanchang,Jiangxi Province from May to June 2023. The interview results were analyzed and summarized to understand the current situation and influencing factors of nurses‘ participation in the antimicrobial stewardship. Results a total of three themes were summarized：the current situation of nurses‘ participation in the antimicrobial stewardship（role diversity,low professional value identity）,the obstacles of nurses‘ participation in the antimicrobial stewardship（lack of professional knowledge,medical hierarchy and Objective medical conditions limitations）,the promoting factors of nurses‘ participation in antimicrobial stewardship（open mind of active participation,positive feedback from the team and scientific and technological innovation）. Conclusion In order to improve nurses‘ contribution to the antimicrobial stewardship,we should try to overcome the obstacles identified in this study,and strengthen the promotion factors,so as to meet the challenge of global antibiotic resistance.

Key words: ICU Nurses, Antimicrobial Stewardship, Antimicrobial Resistance, Multidisciplinary Cooperation, Nursing Management Research

LIU Yan, LU Caiju, ZENG Ling, TANG Jinhua, ZOU Shengwei. A qualitative study on the current status and influencing factors of ICU nurses‘ participation in the antimicrobial stewardship[J]. Chinese Journal of Emergency and Critical Care Nursing, 2024, 5(11): 991-996.

References

[1] WHO. High levels of antibiotic resistance found worldwide,new data shows[EB/OL]. (2018-01-29)[2023-06-16]. https://www.who.int/news/item/29-01-2018-high-levels-of-antibiotic-resistance-found-worldwide-new-data-shows.
[2] Mostaghim M,Snelling T,Bajorek B.Factors associated with adherence to antimicrobial stewardship after-hours[J]. Int J Pharm Pract,2019,27(2):180-190.
[3] Jeffs L,Law MP,Zahradnik M,et al.Engaging nurses in optimizing antimicrobial use in ICUs:a qualitative study[J]. J Nurs Care Qual,2018,33(2):173-179.
[4] Castro-Sánchez E,Bosanquet J,Courtenay M,et al.Nurses:an underused,vital asset against drug-resistant infections[J]. Lancet,2022,400(10354):729.
[5] 刘岩,曾凌,卢才菊,等. 2018—2020年江西省高毒力耐碳青霉烯类肺炎克雷伯菌分子流行病学特征[J]. 中华医院感染学杂志,2023,33(11):1601-1606.
Liu Y,Zeng L,Lu CJ,et al.Molecular epidemiological characteristics of highly virulent carbapenem-resistant Klebsiella pneumoniae in Jiangxi Province from 2018 to 2020[J]. Chin J Nosocomiology,2023,33(11):1601-1606.
[6] NICE. Antimicrobial stewardship:systems and processes for effective antimicrobial medicine use[EB/OL]. (2015-08-18)[2023-06-16]. https://www.nice.org.uk/guidance/ng15/resources/antimicrobial-stewardship-systems-and-processes-for-effective-antimicrobial-medicine-use-pdf-1837273110469.
[7] Olans RN,Olans RD,DeMaria A Jr. The critical role of the staff nurse in antimicrobial stewardship:unrecognized,but already there[J]. Clin Infect Dis,2016,62(1):84-89.
[8] Ladenheim D.Role of nurses in supporting antimicrobial stewardship[J]. Nurs Stand,2018,33(6):55-58.
[9] Hamdy RF,Neal W,Nicholson L,et al.Pediatric nurses‘ perceptions of their role in antimicrobial stewardship:a focus group study[J]. J Pediatr Nurs,2019,48:10-17.
[10] Broom A,Broom J,Kirby E,et al.Nurses as antibiotic brokers:institutionalized praxis in the hospital[J]. Qual Health Res,2017,27(13):1924-1935.
[11] van Gulik N,Hutchinson A,Considine J,et al. Perceived roles and barriers to nurses‘ engagement in antimicrobial stewardship:a Thai qualitative case study[J]. Infect Dis Health,2021,26(3):218-227.
[12] Olans RD,Nicholas PK,Hanley D,et al.Defining a role for nursing education in staff nurse participation in antimicrobial stewardship[J]. J Contin Educ Nurs,2015,46(7):318-321.
[13] Jump RL,Heath B,Crnich CJ,et al.Knowledge,beliefs,and confidence regarding infections and antimicrobial stewardship:a survey of Veterans Affairs providers who care for older adults[J]. Am J Infect Control,2015,43(3):298-300.
[14] Fisher CC,Cox VC,Gorman SK,et al.A theory-informed assessment of the barriers and facilitators to nurse-driven antimicrobial stewardship[J]. Am J Infect Control,2018,46(12):1365-1369.
[15] Best JA,Kim S.The FIRST curriculum:cultivating speaking up behaviors in the clinical learning environment[J]. J Contin Educ Nurs,2019,50(8):355-361.
[16] Merrill K,Hanson SF,Sumner S,et al.Antimicrobial stewardship:staff nurse knowledge and attitudes[J]. Am J Infect Control,2019,47(10):1219-1224.
[17] NMC. Future nurse:standards of proficiency for registered nurses[EB/OL].[2023-06-16]. https://www.nmc.org.uk/globa lasse ts/sited ocume nts/standards-of-proficiency/nurses/future-nurse-profi-ciencies.pdf.
[18] Broom JK,Broom AF,Kirby ER,et al.Clinical and social barriers to antimicrobial stewardship in pulmonary medicine:a qualitative study[J]. Am J Infect Control,2017,45(8):911-916.
[19] Monsees EA,Tamma PD,Cosgrove SE,et al.Integrating bedside nurses into antibiotic stewardship:a practical approach[J]. Infect Control Hosp Epidemiol,2019,40(5):579-584.
[20] Broom J,Broom A,Plage S,et al.Barriers to uptake of antimicrobial advice in a UK hospital:a qualitative study[J]. J Hosp Infect,2016,93(4):418-422.
[21] Alingh CW,van Wijngaarden JDH,van de Voorde K,et al. Speaking up about patient safety concerns:the influence of safety management approaches and climate on nurses‘ willingness to speak up[J]. BMJ Qual Saf,2019,28(1):39-48.
[22] 汪晖,刘于,曾铁英,等. 各国护理人力资源配置政策比较研究的范围综述[J]. 中华护理杂志,2022,57(21):2674-2682.
Wang H,Liu Y,Zeng TY,et al.An international comparative study on nurse staffing policies:a scoping review[J]. Chin J Nurs,2022,57(21):2674-2682.
[23] Ohneberg C,Stöbich N,Warmbein A,et al.Service robotics in nursing care. The preliminary results of a scoping review[J]. Stud Health Technol Inform,2021,281:1075-1076.
[24] Triantafyllidis A,Kondylakis H,Katehakis D,et al.Deep learning in mHealth for cardiovascular disease,diabetes,and cancer:systematic review[J]. JMIR Mhealth Uhealth,2022,10(4):e32344.

A qualitative study on the current status and influencing factors of ICU nurses‘ participation in the antimicrobial stewardship

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