Guidelines for the hospital role of the clinical nurse in antimicrobial stewardship: A scoping review

J Rout, S Essack, P Brysiewicz


Background. Antimicrobial stewardship aims to optimise the use of antimicrobial medicines to preserve the efficacy of these medicines and to contain antimicrobial resistance where possible. Nurses constitute the largest group of healthcare workers; however, the role played by nurses within current antimicrobial stewardship strategies is largely unacknowledged despite nurses being at point-of-care at the hospital bedside.

Objective. To identify recommendations for the antimicrobial stewardship role of the bedside nurse in key global antimicrobial stewardship guidelines.

Methods. Scoping review methodology was used to systematically search published and ‘grey’ literature in PubMed, EBSCOhost, Google Scholar, government websites, and websites of professional societies and organisations. Search dates were 1990 to 2020. Inclusion criteria were English language antimicrobial stewardship guidelines for hospitals. Screening was conducted in two stages for title and abstract and then full text relevancy and documented according to the PRISMA Extension for Scoping Reviews.

Results. Of the 1 824 articles that were retrieved, only 43 met the inclusion criteria. Inclusion of the bedside nurse on the antimicrobial stewardship team occurred in 13.9% (n=6) of the papers. A role for the bedside nurse was recommended in antibiotic stewardship (32.5%; n=14), infection prevention and control (23.2%; n=10), and administration of antimicrobial medicines (20.9%; n=9) of reviewed documents. Other recommendations included the use of evidence-based antimicrobial stewardship (20.9%; n=9), collaboration with other healthcare staff (11.6%; n=5), facilitation of transition of care (18.6%; n=8), and nurse prescription of antibiotics (4.6%; n=2).

Conclusion. This scoping review highlights a slow but incremental increase in recognition of the role of the bedside nurse within the operational hub of antimicrobial stewardship strategies.

Authors' affiliations

J Rout, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

S Essack, Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

P Brysiewicz, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

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Cite this article

Southern African Journal of Critical Care 2021;37(2):70-76. DOI:10.7196/SAJCC.2021.v37i2.481

Article History

Date submitted: 2021-08-06
Date published: 2021-08-24

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