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护士在急性儿科环境中对抗菌药物管理和感染预防策略的知识掌握和实施情况。

Nurses' knowledge and implementation of antimicrobial stewardship and infection prevention strategies in acute paediatric settings.

机构信息

School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University Geelong, Victoria, Australia.

School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University Geelong, Victoria, Australia; Centre for Quality and Patient Safety Research, Epworth Healthcare Partnership, Deakin University Geelong, Victoria, Australia; Centre for Innovation in Infectious Disease and Immunology Research, Deakin University Geelong, Victoria, Australia.

出版信息

J Hosp Infect. 2023 Jul;137:54-60. doi: 10.1016/j.jhin.2023.05.001. Epub 2023 May 7.

Abstract

BACKGROUND

Nurses are the first point of contact for patients and are responsible for monitoring and reporting signs of infection. The COVID-19 pandemic cemented nurses' leadership role in infection prevention. Despite this, nurses' contribution to antimicrobial stewardship initiatives remains under-recognized.

AIM

To determine how paediatric nurses understood their role and contribution to antimicrobial stewardship and infection prevention and control practices in three different acute paediatric wards.

METHODS

Forty-three nurses were recruited from an adolescent ward, an oncology ward, and a surgical ward in a metropolitan tertiary children's hospital for a qualitative exploratory descriptive study.

FINDINGS

Thematic and content analysis derived three themes from the data: understanding of preventable infections; embracing evidence-based guidelines to protect the patient; and roles in preventing and controlling infections and antimicrobial stewardship. Associated subthemes were: desensitized to COVID-19; understanding infection prevention and control precautions; correct use of hospital policy and guidelines; restrictions associated with the use of electronic medical records; understanding of sepsis management and the importance of timely microbiological testing; ambivalence on antimicrobial stewardship roles; and high priority placed on consumer education.

CONCLUSION

Nurses' understanding of their role focused on practices such as performing hand hygiene, standard precautions, and reporting the use of high-risk antimicrobials. A lack of understanding of paediatric COVID-19 transmission and presentations was also reported. Education on best practice in infection prevention and AMS was recognized as crucial for both nurses and parents.

摘要

背景

护士是患者的第一接触点,负责监测和报告感染迹象。COVID-19 大流行巩固了护士在感染预防方面的领导作用。尽管如此,护士对抗菌药物管理举措的贡献仍然未得到充分认可。

目的

确定三名儿科护士在三个不同的急性儿科病房中对抗菌药物管理和感染预防与控制实践的理解、作用和贡献。

方法

在一家大都市三级儿童医院的青少年病房、肿瘤病房和外科病房中招募了 43 名护士,进行定性探索性描述研究。

发现

从数据中得出了三个主题:可预防感染的理解;接受基于证据的指南以保护患者;以及在预防和控制感染和抗菌药物管理方面的作用。相关的子主题包括:对 COVID-19 麻木不仁;了解感染预防和控制预防措施;正确使用医院政策和指南;电子病历使用的限制;了解败血症管理和及时进行微生物检测的重要性;对抗菌药物管理角色的矛盾态度;以及对消费者教育的高度重视。

结论

护士对其角色的理解主要集中在执行手部卫生、标准预防措施和报告使用高风险抗菌药物等实践上。还报告了对儿科 COVID-19 传播和表现的理解不足。针对感染预防和抗菌药物管理最佳实践的教育被认为对护士和家长都至关重要。

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本文引用的文献

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Antimicrobial stewardship: a COVID casualty?抗菌药物管理:新冠疫情的牺牲品?
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