Implementation of a nurse-driven antibiotic engagement tool in 3 hospitals
Implementation of a nurse-driven antibiotic engagement tool in 3 hospitals
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DOI：
10.1016/j.ajic.2020.07.002
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发表时间：
2020-12-01
影响因子：
4.9
通讯作者：
Goldman, Jennifer
中科院分区：
文献类型：
--
作者：
Monsees, Elizabeth;Lee, Brian;Goldman, Jennifer
背景资料：护士在实施抗生素管理的关键，但是，标准化的流程是lacking.Methods：这项可行性研究测试实施护士驱动的抗生素参与工具（AET），解决抗生素的适应症，持续时间，停药，静脉到口服转换。一项由医生开发的调查测量了4个临床单位的护士满意度、信心和对抗生素护理计划的理解。使用Mann-Whitney U比较不同时间段之间的差异。非参数汇总分布评估AET use.Results：结果从121调查，71（36%）presurvey，50（24%）postsurvey。13名注册护士报告对AET用途：（1）轻松（中位数：4 [2.25，4]）;（2）时间（中位数：4 [3.5，4.5]）;（3）有助于促进提问（中位数：4 [3，4]）;（4）帮助找到抗生素信息（中位数：4 [2.5，4]）;（5）增加抗生素讨论的信心（中位数4 [3，4]）。计划的抗生素治疗的持续时间是不清楚的护士13.9%的时间与护士确定的持续时间差异在22.8%的提交AACH.Conclusions：AET促进跨专业的对话。在领导者和护士影响者参与管理推广的环境中，使用率较高。明确抗生素使用时间是未来护理抗生素管理工作的主要领域。(C)2020感染控制和流行病学专业人员协会，Inc.爱思唯尔公司出版All rights reserved.
Background: Nurses are key in implementing antibiotic stewardship; however, standardized processes are lacking.Methods: This feasibility study tested implementation of a nurse-driven antibiotic engagement tool (AET) that addressed antibiotic indication, duration, discontinuation, and intravenous to oral conversion. An investigator-developed survey measured nurse satisfaction, confidence, and understanding of antibiotic plan of care among 4 clinical units. Mann-Whitney U was used to compare differences between time periods. Non parametric summary distributions assessed AET use.Results: Results from 121 surveys were available; 71 (36%) presurvey, 50 (24%) postsurvey. Thirteen registered nurses reported satisfaction or agreement with AET use: (1) ease (median: 4 [2.25, 4]); (2) time (median: 4 [3.5, 4.5]); (3) helped facilitate asking questions (median: 4 [3, 4]); (4) helped find antibiotic information (median: 4 [2.5, 4]); and (5) increased confidence in antibiotic discussions (median 4 [3, 4]). Planned duration of antibiotic therapy was unclear to nurses 13.9% of the time with nurses identifying duration discrepancies in 22.8% of submitted AETs.Conclusions: The AET promoted interprofessional conversation. Use was higher in settings where leaders and nurse influencers were involved in stewardship promotion. Clarifying antibiotic duration is a prime area for future nursing antibiotic stewardship efforts. (C) 2020 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.