Gomez Jessica, Domonoske Christine, Chang Michael
AORN J. 2023 May;117(5):291-299. doi: 10.1002/aorn.13911.
Since 1942, health care personnel have administered antibiotics in the United States to prevent and treat a variety of infections, including surgical site infections. Bacteria can mutate and develop resistance after frequent and repeated antibiotic exposure, thus limiting the antibiotic's effectiveness. Because antibiotic resistance can be passed from one bacterium to another, antibiotics are the only class of medications where use in one patient may negatively affect clinical outcomes in another. Antibiotic stewardship (AS) focuses on appropriate antibiotic selection, dosing, route, and duration of therapy; it seeks to minimize unplanned consequences, such as resistance and toxicity. Although there is a lack of literature on AS specific to perioperative nurses, general nursing practice includes AS activities (eg, assessing patient allergies, adhering to antibiotic administration recommendations). Perioperative nurses should participate in AS activities and use evidence-based strategies to communicate effectively with health care team members when advocating for appropriate antibiotic use.
自1942年以来,美国的医护人员一直在使用抗生素来预防和治疗各种感染,包括手术部位感染。细菌在频繁和反复接触抗生素后会发生变异并产生耐药性,从而限制了抗生素的有效性。由于抗生素耐药性可以从一种细菌传递到另一种细菌,抗生素是唯一一类在一名患者身上使用可能会对另一名患者的临床结果产生负面影响的药物。抗生素管理(AS)侧重于适当的抗生素选择、剂量、给药途径和治疗持续时间;它旨在尽量减少意外后果,如耐药性和毒性。尽管缺乏针对围手术期护士的抗生素管理文献,但一般护理实践包括抗生素管理活动(例如,评估患者过敏情况、遵循抗生素给药建议)。围手术期护士应参与抗生素管理活动,并在倡导合理使用抗生素时,运用循证策略与医护团队成员进行有效沟通。