Gupta Renu, Sharma Sangeeta, Bablani Vineeta, Manocha Sneh, Srinivasan Muthuvenkatachalam
Institute of Human Behaviour and Allied Sciences, Dilshad Garden, Delhi 110095, India.
Ex Senior Lecturer, Ahilya Bai College of Nursing, New Delhi 110002, India.
Nurse Educ Pract. 2025 Jan;82:104223. doi: 10.1016/j.nepr.2024.104223. Epub 2024 Dec 5.
This study aimed to evaluate nurses' baseline understanding of diagnostic stewardship (DS) principles and the impact of an educational intervention on their knowledge and practices.
Antimicrobial resistance (AMR), driven by inappropriate antibiotic use, is a critical global health threat. Effective antimicrobial stewardship (AMS) requires integrating DS to ensure accurate diagnoses through proper test requisition, specimen handling and timely reporting. However, understanding and implementation of DS remains poor in general, contributing to inappropriate antibiotic use. Nurses play a crucial role in DS, yet their potential is underused, highlighting the need for targeted educational interventions.
A quasi-experimental pre-post study conducted from September 2022 to March 2023.
A gap analysis assessed nurses' baseline knowledge of DS informing the development of an online training program. In the intervention phase, pre-and post-assessments measured knowledge improvements after the intervention.
In phase 1, 310 out of 517 nurses completed the gap analysis, with an average score of 6.59 out of 20 (range: 2-13; median score: 6.5). In phase 2, 228 of 613 nurses completed both pre- and post-tests, showing a significant improvement in scores from 4.69 (median 5), in pre-test to 6.22 (median 6) in post-test.
The educational intervention significantly enhanced nurses' knowledge of AMR, specimen selection, culture indications and collection techniques. Sustained training is vital to strengthen diagnostic practices, reduce inappropriate antimicrobial use and combat AMR.
本研究旨在评估护士对诊断管理（DS）原则的基线理解，以及教育干预对其知识和实践的影响。
不适当使用抗生素导致的抗菌药物耐药性（AMR）是全球重大的健康威胁。有效的抗菌药物管理（AMS）需要整合DS，以通过正确的检验申请、标本处理和及时报告确保准确诊断。然而，总体而言，对DS的理解和实施仍然较差，这导致了抗生素的不适当使用。护士在DS中起着关键作用，但其潜力尚未得到充分利用，这凸显了针对性教育干预的必要性。
2022年9月至2023年3月进行的一项准实验前后对照研究。
进行差距分析，评估护士对DS的基线知识，为在线培训项目的开发提供依据。在干预阶段，通过前后评估来衡量干预后知识的改善情况。
在第一阶段，517名护士中的310名完成了差距分析，平均得分20分中的6.59分（范围：2 - 13分；中位数得分：6.5分）。在第二阶段，613名护士中的228名完成了前测和后测，得分从测试前的4.69分（中位数5分）显著提高到测试后的6.22分（中位数6分）。
教育干预显著提高了护士对抗菌药物耐药性、标本选择、培养指征和采集技术的知识。持续培训对于加强诊断实践、减少不适当的抗菌药物使用和对抗抗菌药物耐药性至关重要。
