Rout J, Brysiewicz P
School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
South Afr J Crit Care. 2020 Jul 30;36(1). doi: 10.7196/SAJCC.2020.v36i1.410. eCollection 2020.
Antimicrobial stewardship has become an important initiative within intensive care units in the global fight against antimicrobial resistance. Support for nurses to participate in and actively direct antimicrobial stewardship interventions is growing however, there may be barriers that impede the development of this nursing role.
To explore the views of healthcare professionals regarding barriers to the antimicrobial stewardship role of the nurse in intensive care in a private hospital in KwaZulu-Natal, South Africa.
Using a qualitative research approach, purposive sampling was used to identify fifteen participants from the disciplines of nursing, surgery, anaesthetics, internal medicine, microbiology, and pharmacy in a general intensive care unit. Content analysis was used to code data obtained from each individual interview.
The following categories and subcategories were derived: regarding barriers to the role of the nurse in antimicrobial stewardship: (i) lack of collaboration (subcategories: not participating in the antimicrobial stewardship programme, no feedback about antimicrobial resistance in the unit, and not part of decision-making); (ii) inadequate knowledge (subcategories: not understanding infection prevention and control, missing the link between laboratory results and start of treatment, and poor knowledge of antibiotics and their administration); and (iii) inexperienced nurses (subcategories: shortage of intensive care nurses, lack of experienced nurses, and inadequate nursing staff to provide in-service training).
The nursing role within antimicrobial stewardship was negatively affected by both staffing and collaborative difficulties, which impacted on the implementation of antimicrobial stewardship within the unit.
Nurses are not well-integrated into antimicrobial stewardship. Insufficient training and education on aspects of antimicrobial stewardship are available to nurses.
在全球抗击抗菌药物耐药性的斗争中，抗菌药物管理已成为重症监护病房的一项重要举措。支持护士参与并积极指导抗菌药物管理干预措施的呼声日益高涨，然而，可能存在一些障碍阻碍这一护理角色的发展。
探讨医疗保健专业人员对南非夸祖鲁 - 纳塔尔省一家私立医院重症监护病房中护士抗菌药物管理角色障碍的看法。
采用定性研究方法，通过目的抽样从综合重症监护病房的护理、外科、麻醉、内科、微生物学和药学等学科中确定了15名参与者。使用内容分析法对从每次个人访谈中获得的数据进行编码。
得出以下类别和子类别：关于护士在抗菌药物管理中角色的障碍：（i）缺乏协作（子类别：未参与抗菌药物管理计划、未获得有关病房内抗菌药物耐药性的反馈、未参与决策）；（ii）知识不足（子类别：不理解感染预防与控制、未建立实验室结果与治疗开始之间的联系、对抗生素及其给药知识匮乏）；（iii）护士经验不足（子类别：重症监护护士短缺、缺乏经验丰富的护士、提供在职培训的护理人员不足）。
抗菌药物管理中的护理角色受到人员配备和协作困难的负面影响，这影响了病房内抗菌药物管理的实施。
护士在抗菌药物管理中未得到很好的整合。护士在抗菌药物管理方面缺乏足够的培训和教育。
