Antimicrobial stewardship (AMS) means using antibiotics responsibility to preserve their future effectiveness. The nurse’s role in AMS has always been crucial but during a viral pandemic should this role be given more or less priority?
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to cause widespread devastation globally. Although it is a virus and so antibiotics have no effect on it, since the emergence of covid-19 the Centers for Disease Control and Prevention (CDC) have found an increase in antibiotic use. This may be for a number of reasons; some patients will have or develop secondary bacterial infections such as pneumonia, which do then require antibiotics; there is clinical uncertainty about covid-19 infections; there has been a strain on healthcare systems; inadequate testing; myths around possible therapies; telehealth consultations and a halt to current AMS programmes.
This pandemic highlights multiple areas in which the nurse can support AMS. One of the SHIP team and an international group of experts, collaborated on developing AMS competencies for nurses and have now just published a piece in the Journal of Hospital Infection which suggests ways in which nurses can apply these competencies to help the Covid-19 response efforts. Nurses can help through their role in supporting diagnosis (e.g. differentiating between viral and bacterial infections); engaging patients and involving them in decision-making, for example in managing expectations for an antibiotic; interprofessional collaboration especially when there has been a reconfiguration of some services and redeployment of staff; leadership and influence in communication and coordinating holistic patient care (e.g. discussing treatment decisions and management plans with colleagues, patients and carers).
Therefore, the nurse’s role in AMS during this current pandemic should still be a priority. Consequently, supporting nurses in carrying out their AMS role will send out a strong message about the importance of responsible antimicrobial management.
Original article: Courtenay M, Burnett E, Castro-Sánchez E, Moralez de Figueiredo R, Du Toit B, Gallagher R, Gotterson F, Kennedy H, Manias E, McEwen J, Ness V, Olans R, Padoveze MC, Preparing nurses for COVID-19 response efforts through involvement in antimicrobial stewardship programmes, Journal of Hospital Infection, https://doi.org/10.1016/j.jhin.2020.06.011