Shining a light on the “hidden figures”: what does the literature tell us about the role of nurses in Antimicrobial Stewardship (AMS)?

Ms Fiona Gotterson1, A/Prof Kirsty Buising1,2,3, Professor Elizabeth Manias4,5,6

1National Centre For Antimicrobial Stewardship, Melbourne , Australia,

2Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Australia,

3University of Melbourne, Melbourne, Australia,

4Deakin University, Faculty of Health, School of Nursing and Midwifery, Melbourne, Australia,

5The University of Melbourne, The Royal Melbourne Hospital, Melbourne, Australia,

6The University of Melbourne, Melbourne School of Health Sciences, Melbourne, Australia


Introduction: Despite their significance to the health workforce and established role in medication management, comparatively little attention has been paid to the nurse role in antimicrobial stewardship (AMS), with dialogue focused mostly on responsibilities of doctors and pharmacists. This presentation will present selected findings from a review of the literature exploring the nurse’s role in AMS.

Methods: Using the search terms “nurses”, “antimicrobials” and “antimicrobial stewardship”, the author searched Medline, Embase, Cinahl and Google Scholar for papers published since the start of the data base to March 2017, related to humans and published in English. Papers of all types were included, (reviews, opinion pieces, intervention studies). Each was reviewed by a single researcher with themes identified in the text.

Results: Many papers were identified that offered opinions about potential roles for nurses, and educational needs, but few original studies were found. Identified themes included: Education as an intervention (the need to improve nursing knowledge about antimicrobials); and Mediation (nurses “brokering” information between doctors and patients to influence antimicrobial prescribing) as key aspect for further exploration.

Conclusion: The literature describes the potential role and factors which may enable nurse participation in AMS. Further research is needed to better inform how best to meet educational and support needs, and how these actions might best be undertaken.

Fiona Gotterson is a registered nurses, with extensive experience in nurse education and quality and safety. She has worked on the National HAI Prevention and Antimicrobial Stewardship Project at the Australian Commission on Safety and Quality in Health Care. She is currently a PhD Fellow at the National Centre for Antimicrobial Stewardship, looking at the Role of Nurses in AMS.