The Role of the Registered Nurse in Antimicrobial Stewardship.
There have been many news reports over the last several years regarding the development of multi-drug resistant organisms related to the use of antibiotics. This is not a new problem as it has occurred since the development of penicillin in the 1940s and continues today as new antibiotics are developed. What is alarming is how quickly bacteria become resistant to antibiotics! This will not improve unless healthcare providers address the issue and implement antimicrobial stewardship strategies to address the risks. Registered Nurses are in a key position to help combat this crisis. Simply stated antimicrobial stewardship is providing the correct antibiotic for the indication, dose, duration, and route of administration.
In 2017, the ANA and CDC publish a joint White Paper describing the role of the registered nurse in hospital antibiotic stewardship activities. In addition, the Joint Commission implemented a new standard in the Medication Management chapter requiring hospitals to establish an antimicrobial stewardship committee effective January 2017. Many health care facilities have implemented committees to address antimicrobial stewardship across the continuum of care. Become involved by volunteering to be on the committee. It is important that everyone is at the table and addressing the use of antimicrobial agents.
As nurses our role in antimicrobial stewardship to ensure the safe and appropriate use of antimicrobials includes:
* Collect cultures using appropriate technique before starting antibiotics
* Review culture results and sensitivities and ordered antibiotics
* Be aware of indication and intended duration of antibiotics
* Notify the provider of adverse effects or patient refusal of antibiotics
* Take a detailed allergy history (A penicillin allergy label has been associated with increased selection of antibiotic-resistant organisms, longer hospital stay and increased cost.)
* Advocate for removal of invasive devices such as urinary catheters and central lines when no longer needed
* Promote immunization for children and adults
Additional information including the ANA/CDC White Paper can be found at https://www.cdc.gov/antibiotic-use/healthcare/index.html.
Lisa Caffery, MS, BSN, RN-BC, CIC, FAPIC
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|Title Annotation:||REGION NEWS|
|Publication:||Iowa Nurse Reporter|
|Date:||Apr 1, 2019|
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