Filipe Susana, Santos-Costa Paulo, Bastos Celeste, Castilho Amélia
Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3046-851 Coimbra, Portugal.
Local Health Unit of Baixo Mondego, 3094-001 Figueira da Foz, Portugal.
Nurs Rep. 2025 Jun 12;15(6):216. doi: 10.3390/nursrep15060216.
Antimicrobial resistance (AMR) is a pressing global health challenge, driving the need for effective antimicrobial stewardship (AMS) programmes. Despite nurses' critical role in care delivery, their involvement in AMS remains under-recognized. : This mapping review aims to identify barriers and facilitators influencing nurses' engagement in AMS programmes and examine nursing-sensitive outcomes associated with their participation, using Irvine's Nursing Role Effectiveness Model (NREM) as a guiding framework. : A systematic mapping review was conducted following Joanna Briggs Institute (JBI) guidance and reported using the PRISMA-ScR checklist. The protocol was registered on the Open Science Framework. Searches were conducted in MEDLINE, CI-NAHL, Scopus, LILACS, Scielo, and grey literature sources. Data were extracted and categorized according to the NREM domains: structure, process, and outcomes. : Thirty-two studies were included. Key barriers included limited AMS knowledge, role ambiguity, hierarchical dynamics, communication gaps, and lack of standardized nursing outcomes. Facilitators encompassed targeted AMS education, participation in multidisciplinary discussions, managerial support, and defined nursing roles. Nurse-led interventions showed potential to improve infection control and antibiotic administration, although standardized outcome reporting remains scarce. : Framed by the NREM, this review underscores the essential contribution of nurses to AMS. Addressing structural barriers, enhancing role clarity, and fostering interdisciplinary collaboration are critical to enabling nurses' full participation. Strengthening nursing engagement in AMS not only supports effective antimicrobial use and patient safety but also reinforces health system resilience and sustainability.
抗菌药物耐药性（AMR）是一项紧迫的全球卫生挑战，这促使人们需要有效的抗菌药物管理（AMS）计划。尽管护士在医疗服务中发挥着关键作用，但他们在抗菌药物管理中的参与仍未得到充分认可。本图谱综述旨在确定影响护士参与抗菌药物管理计划的障碍和促进因素，并使用欧文的护理角色效能模型（NREM）作为指导框架，研究与其参与相关的护理敏感结局。按照乔安娜·布里格斯研究所（JBI）的指导方针进行了系统的图谱综述，并使用PRISMA-ScR清单进行报告。该方案已在开放科学框架上注册。检索了MEDLINE、护理及健康照护领域数据库（CINAHL）、Scopus、拉丁美洲及加勒比地区健康科学数据库（LILACS）、科学电子在线数据库（Scielo）以及灰色文献来源。根据NREM的领域：结构、过程和结果对数据进行提取和分类。纳入了32项研究。主要障碍包括抗菌药物管理知识有限、角色模糊、层级动态、沟通差距以及缺乏标准化的护理结局。促进因素包括针对性的抗菌药物管理教育、参与多学科讨论、管理支持以及明确的护理角色。由护士主导的干预措施显示出改善感染控制和抗生素使用的潜力，尽管标准化结局报告仍然很少。以NREM为框架，本综述强调了护士对抗菌药物管理的重要贡献。解决结构障碍、提高角色清晰度以及促进跨学科合作对于使护士充分参与至关重要。加强护士在抗菌药物管理中的参与不仅有助于有效使用抗菌药物和保障患者安全，还能增强卫生系统的恢复力和可持续性。
