INTEGRATION OF CRITICAL CARE NURSES IN ANTIMICROBIAL STEWARDSHIP; OPPORTUNITIES AND BARRIERS AT A COUNTY REFERRAL HOSPITAL IN KENYA
INTEGRATION OF CRITICAL CARE NURSES IN ANTIMICROBIAL STEWARDSHIP; OPPORTUNITIES AND BARRIERS AT A COUNTY REFERRAL HOSPITAL IN KENYA
Joseph Waithanji Chege - Student (Critical Care Nursing), School of Health Sciences, Kenyatta University, Kenya
Dr. Nickcy Mbuthia (PhD, RN) - Lecturer and Researcher, School of Health Sciences, Kenyatta University, Kenya
Grace Gachuiri (RN) - Lecturer, School of Health Sciences, Kenyatta University, Kenya
ABSTRACT
Antimicrobial stewardship optimizes appropriate use of antimicrobials through agent selection, route, dosing, and duration of therapy. It serves to optimize clinical outcomes of patients and limit adverse reactions of antimicrobials. Nurses are frontline implementers of antimicrobial stewardship. However, they face issues on inter-professional jurisdiction, hierarchical power relations within hospitals and limited training on antimicrobial stewardship. The main objective of this study is to explore the integration of nurses into antimicrobial stewardship activities in the critical care unit at Thika Level 5 Hospital, Kenya. The study used exploratory descriptive qualitative research design. Data collection was done through semi-structured interviews and NVIVO 14 software was used for thematic analysis of data. A total of 11 nurses working in the intensive care unit were interviewed. Patient advocacy, communication and collaboration, monitoring and documenting, and patient education and empowerment emerged as important roles that nurses play in antimicrobial stewardship. Participants highlighted continuous medical education, inclusion of antimicrobial stewardship in formal nursing education, team work and organization support as major facilitators of nurses’ roles in antimicrobial stewardship. The study findings revealed that stringent regulatory requirements, heavy workload, poorly regulated systems and limited knowledge on antimicrobial stewardship as the major barriers that limit nurses’ role in antimicrobial stewardship. Nurses’ inputs in decision making process on treatment plans and antimicrobial use is invaluable in promoting judicious use of antimicrobials. Future research should focus on redefining the nature, scope and influence of perceived nurses’ role in antimicrobial stewardship.
