L H Wong1, M A Bin Ibrahim2, H Guo3, A L H Kwa4, L H W Lum5, T M Ng6, J S Chung7, J Somani8, D C B Lye9, A Chow10. 1. Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore. 2. Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore; Department of Psychology, School of Social and Health Sciences, James Cook University, Singapore Campus, Singapore. 3. Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore; Infectious Disease Research and Training Office, National Centre for Infectious Diseases, Singapore. 4. Department of Pharmacy, Singapore General Hospital, Singapore; Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore. 5. Division of Infectious Diseases, National University Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore. 6. Department of Pharmacy, Tan Tock Seng Hospital, Singapore. 7. Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Infectious Diseases, Singapore General Hospital, Singapore. 8. Division of Infectious Diseases, National University Hospital, Singapore. 9. Infectious Disease Research and Training Office, National Centre for Infectious Diseases, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore. 10. Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore. Electronic address: Angela_Chow@ttsh.com.sg.
Abstract
BACKGROUND: Inappropriate antibiotics use and antimicrobial resistance (AMR) are increasingly becoming global health issues of great concern. Despite the established antibiotic stewardship programmes (ASPs) in many countries, limited efforts have been made to engage nurses and clearly define their roles in ASPs. AIM: An exploratory qualitative study was conducted to understand the facilitators and barriers that impact nurses' involvement and empowerment in antibiotic stewardship. METHODS: Focus group discussions (FGDs) were conducted with purposively sampled nurses from three major public hospitals in Singapore. FGDs were audio-recorded and transcribed verbatim. Data were analysed using Applied Thematic Analysis and interpreted using the Social Ecological Model. FINDINGS: At the intrapersonal level, nurses felt empowered in carrying out their roles in antibiotic administration. They saw themselves as gatekeepers to ensure that the prescribed antibiotics were administered appropriately. However, nurses felt they lacked the knowledge and expertise in antibiotic use and AMR prevention. At the interpersonal level, this deficit in knowledge and expertise in antibiotic use impacted how they were perceived by patients and caregivers as well as their interactions with the primary care team when voicing outpatient safety concerns and antibiotic administration suggestions. At the organizational level, nurses relied on drug administration guidelines to ensure appropriate antibiotic administration and as a safety net when physicians questioned their clinical practice. At the community level, nurses felt there was a lack of awareness and knowledge on antibiotic use among the general population. CONCLUSION: These findings provide important insights to harness the contributions of nurses, and to formally acknowledge and enlarge their roles in ASPs.
BACKGROUND: Inappropriate antibiotics use and antimicrobial resistance (AMR) are increasingly becoming global health issues of great concern. Despite the established antibiotic stewardship programmes (ASPs) in many countries, limited efforts have been made to engage nurses and clearly define their roles in ASPs. AIM: An exploratory qualitative study was conducted to understand the facilitators and barriers that impact nurses' involvement and empowerment in antibiotic stewardship. METHODS: Focus group discussions (FGDs) were conducted with purposively sampled nurses from three major public hospitals in Singapore. FGDs were audio-recorded and transcribed verbatim. Data were analysed using Applied Thematic Analysis and interpreted using the Social Ecological Model. FINDINGS: At the intrapersonal level, nurses felt empowered in carrying out their roles in antibiotic administration. They saw themselves as gatekeepers to ensure that the prescribed antibiotics were administered appropriately. However, nurses felt they lacked the knowledge and expertise in antibiotic use and AMR prevention. At the interpersonal level, this deficit in knowledge and expertise in antibiotic use impacted how they were perceived by patients and caregivers as well as their interactions with the primary care team when voicing outpatient safety concerns and antibiotic administration suggestions. At the organizational level, nurses relied on drug administration guidelines to ensure appropriate antibiotic administration and as a safety net when physicians questioned their clinical practice. At the community level, nurses felt there was a lack of awareness and knowledge on antibiotic use among the general population. CONCLUSION: These findings provide important insights to harness the contributions of nurses, and to formally acknowledge and enlarge their roles in ASPs.
Authors: K N Schneider; C L Correa-Martínez; G Gosheger; C Rickert; D Schorn; A Mellmann; V Schwierzeck; S Kampmeier Journal: Arch Orthop Trauma Surg Date: 2020-06-10 Impact factor: 3.067
Authors: Lok Hang Wong; Evonne Tay; Shi Thong Heng; Huiling Guo; Andrea Lay Hoon Kwa; Tat Ming Ng; Shimin Jasmine Chung; Jyoti Somani; David Chien Boon Lye; Angela Chow Journal: Antibiotics (Basel) Date: 2021-11-24