Staff nurses as antimicrobial stewards: An integrative literature review

- There are significant national efforts to advance antimicrobial stewardship across clinical settings.
- There is a lack of research exploring staff nurse integration in antimicrobial management.
- Evaluating the clinical impact of staff nurses as stewards and the correlation to patient outcomes is needed.

BackgroundGuidelines on antimicrobial stewardship emphasize the importance of an interdisciplinary team, but current practice focuses primarily on defining the role of infectious disease physicians and pharmacists; the role of inpatient staff nurses as antimicrobial stewards is largely unexplored.MethodsAn updated integrative review method guided a systematic appraisal of 13 articles spanning January 2007-June 2016. Quantitative and qualitative peer-reviewed publications including staff nurses and antimicrobial knowledge or stewardship were incorporated into the analysis.ResultsTwo predominant themes emerged from this review: (1) nursing knowledge, education, and information needs; and (2) patient safety and organizational factors influencing antibiotic management.DiscussionFocused consideration to empower and educate staff nurses in antimicrobial management is needed to strengthen collaboration and build an interprofessional stewardship workforce.ConclusionsFurther exploration on the integration and measurement of nursing participation is needed to accelerate this important patient safety initiative.