Deakin University Geelong, Australia, School of Nursing and Midwifery, Centre for Quality and Patient Safety in Institute for Health Transformation, Burwood, Australia.
Deakin University Geelong, Australia, School of Nursing and Midwifery, Centre for Quality and Patient Safety in Institute for Health Transformation, Burwood, Australia.
Am J Infect Control. 2021 May;49(5):622-639. doi: 10.1016/j.ajic.2020.11.025. Epub 2020 Dec 5.
Infection prevention and control precautions help to decrease microbial transmission, and through the appropriate use of antibiotics, Antimicrobial Stewardship programs aim to decrease the prevalence and emergence of Antimicrobial Resistance.
A systematic review was undertaken to critically appraise and synthesise evidence for nurses', children's and parents' knowledge and understanding of antimicrobial stewardship, and of infection prevention and control in acute paediatric care settings. The Preferred Reporting Items for Systematic reviews and Meta-Analyses guided the review. Studies were included if they examined the factors that contributed to nurses' adherence to, or consumers' practice in relation to, antimicrobial stewardship and infection prevention and control.
Of the 16,957 papers identified, 50 studies conducted in acute paediatric settings met the eligibility criteria, and were included. Most studies were of low methodological quality. Fourteen studies evaluated nurses' knowledge and self-reported adherence to Infection Prevention and Control principles and identified consistent practice gaps by nurses. Six studies evaluating the effectiveness of education programs reported modest improvements in nurses' knowledge and adherence to infection prevention and control. There were 15 studies, that investigated consumers' involvement in infection prevention and control that identified the following themes: Consumer knowledge and attitudes to infection prevention and control and transmission-based precautions, and parents' willingness to take an active role in infection prevention. Six studies focused on paediatric nurses' role in antimicrobial stewardship, exploring the following themes: (1) nurses' understanding and beliefs of antimicrobial stewardship roles, and (2) barriers to nurses taking a greater role in antimicrobial stewardship. Nine studies explored the role of consumers in antimicrobial stewardship and identified consumers' misconceptions about the benefits and downplayed concerns regarding antibiotic use.
Although consumers articulated a willingness to be actively involved in infection prevention, observed practice remained lower than that required to consistently prevent infection transmission.
These findings highlight a critically important gap in current practice. In relation to optimal use of antimicrobials, although paediatric nurses were involved in supporting antimicrobial stewardship processes and educating consumers, they identified limited antimicrobial stewardship knowledge. Consumers appeared to lack understanding about the benefits of antibiotics and negated concerns regarding antibiotic use.
感染预防和控制措施有助于减少微生物传播，而通过合理使用抗生素，抗菌药物管理计划旨在减少抗菌药物耐药性的流行和出现。
进行了系统评价，批判性地评估和综合了有关护士、儿童和家长对抗菌药物管理和急性儿科护理环境中感染预防和控制的知识和理解的证据。《系统评价和荟萃分析的首选报告项目》指导了这项审查。如果研究考察了有助于护士遵守或消费者实践抗菌药物管理和感染预防和控制的因素，则纳入研究。
在确定的 16957 篇论文中，有 50 项在急性儿科环境中进行的研究符合入选标准，并被纳入。大多数研究的方法学质量较低。14 项研究评估了护士对感染预防和控制原则的知识和自我报告的遵守情况，并发现了护士在实践中的一致差距。6 项评估教育计划效果的研究报告称，护士对抗感染预防和控制的知识和遵守情况有适度的提高。有 15 项研究调查了消费者参与感染预防和控制，确定了以下主题：消费者对感染预防和控制以及基于传播的预防措施的知识和态度，以及家长愿意在感染预防中发挥积极作用。6 项研究专注于儿科护士在抗菌药物管理中的作用，探讨了以下主题：（1）护士对抗菌药物管理角色的理解和信念，以及（2）护士在抗菌药物管理中发挥更大作用的障碍。9 项研究探讨了消费者在抗菌药物管理中的作用，并发现消费者对抗生素使用的益处存在误解，并淡化了对使用抗生素的担忧。
尽管消费者表示愿意积极参与感染预防，但观察到的实践仍然低于持续预防感染传播所需的水平。
这些发现突出了当前实践中一个非常重要的差距。在抗生素的最佳使用方面，尽管儿科护士参与支持抗菌药物管理过程和教育消费者，但他们对抗菌药物管理知识的了解有限。消费者似乎缺乏对抗生素益处的理解，并否认了对抗生素使用的担忧。
