Association for Professionals in Infection Control and Epidemiology Annual Conference
Association for Professionals in Infection Control and Epidemiology Annual Conference
June 19, 2018
2 min read

Nurses ‘overlooked and underutilized’ in antimicrobial stewardship efforts

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Photo of Cindy Hou
Cindy Hou

Nurses are an “overlooked and underutilized” part of the effort to reduce the inappropriate use of antibiotics, according to the results of a new study.

Cindy Hou, DO, infection control officer with Jefferson Health in New Jersey, presented research at the conference of the Association for Professionals in Infection Control and Epidemiology, or APIC, showing that educating nurses and achieving their buy-in can strengthen antimicrobial stewardship programs.

“Our findings show that nurses have been overlooked and underutilized in antimicrobial stewardship programs (ASPs),” Hou said in a press release. “Changing the culture and empowering nurses to speak up about antimicrobial stewardship leads to closer team coordination and cross-discipline collaboration, which ultimately saves lives.”

Hou and colleagues noted that physicians, pharmacists and microbiology staff often make up ASPs, but the nurse’s role has not received the same attention. At Jefferson Health in New Jersey, they opened participation in ASPs to nursing leadership, educators, performance improvement and infection control staff to achieve buy-in and sought input from nurse leadership. They shared a computer-based learning module on antimicrobial stewardship across three hospitals in the system, with compliance rates reaching as high as 97%.

Results from a 10-question quiz on antibiotic usage showed gaps in comprehension among nurses of antimicrobial stewardship principles. ICU clinical nurses were more likely to be aware of how to interpret antibiotic susceptibility results of cultures and how to interpret nonsusceptibility results compared with non-ICU nurses (92.3% vs. 87.6% and 82.7% vs. 78.6%, respectively).

Most nurses (93.8%) incorporated microbiology in sign-out reporting. However, just half of clinical nurses checked susceptibility results of cultures before administering antibiotics. If cultures showed resistance, just 65.1% of nurses reported notifying the physician, Hou and colleagues reported.

They called nursing “the missing link” in antibiotic stewardship and said nurses should be part of the backbone of every ASP program.

“This study shows that by engaging with nurses and pushing for greater team collaboration, major progress can be made on ASPs, which is essential to help reduce the threat of antibiotic resistance,” APIC President Janet Haas, PhD, Rn, said in the release. – by Bruce Thiel


Hou C, et al. ASR-46: The missing link with a path less traveled: Incorporating an aggressive nursing strategy in antimicrobial stewardship. Presented at: APIC 2018; June 13-15, 2018; Minneapolis.

Disclosure: Hou reports no relevant financial disclosures.