Nurses Play a Critical Role in Infection Prevention, Treatment, & Antibiotic Stewardship

By the bioMérieux Connection Editors

Tomorrow marks the 39th annual International IV Nurses Day, created in 1980 by the Infusion Nurses Society to acknowledge the special skills that IV nurses bring to a medical team.  Over time, infusion therapy has become much more common, shifting from a measure used only for extremely ill patients to a treatment method for more than 90 percent of hospitalized patients.

Most hospital staff nurses regularly assist with infusion therapy and certified registered nurses of infusion (CNRI®s) can offer additional expertise and experience.  Since most patients who are admitted to a hospital get IV access at some point during their stay, proper placement and care are vital for patient comfort.

IV nurses’ expertise with vascular access devices (VADs), as well as peripherally inserted central catheters (PICCs) is especially valuable when it comes to infection prevention.  An article in Advance Healthcare Network Nursingdiscusses a study conducted at Michael Reese Hospital and Medical Center in Chicago, where researchers concluded, “The presence of a dedicated IV therapy service team significantly lessens the incidence of IV-related complications. The study noted that uniform catheter insertion technique and routine IV site monitoring contribute to the reduced rate. However, the greatest single factor contributing to lower complication rates is the timely removal of IV catheters.”

Additionally, many patients in the hospital receive antibiotic treatment intravenously, and because nurses are on the front lines of patient care, they have an important role to play in antibiotic stewardship.  Historically, nurses have been excluded from guidelines for developing and implementing antibiotic stewardship programs (ASPs), however, recently there has been more dialog on the subject, and guidelines have evolved to include nurses as part of the ASP team.

In a pilot program at the Pomona Valley Medical Center in Los Angeles reported in Contagion Live, “The staff nurses proved to be an asset to the goals of the interdisciplinary rounds and fitting advocates of antibiotic stewardship. Their routine duties, including continuous monitoring of patient symptoms and responses to therapy, obtaining laboratory testing and receiving results, administering and reviewing medications, and assisting in the coordination of patient discharge, put them in an ideal position to perform timely intervention.”

As the program progressed, nurses began to have discussions more frequently with prescribers about the necessity of antibiotics, acid suppressants, and invasive catheters. Some of those discussions resulted in agreement between the nurse and prescriber, and appropriate therapeutic modifications or discontinuations were made.

The authors of the Contagion Live article conclude that, “Nurses are valuable contributors to antibiotic stewardship efforts but are widely underrecognized and thus underutilized for such roles. It is our hope that other institutions will actively involve their bedside nursing staff in antibiotic stewardship efforts, as well as share their approaches and outcomes, to shed more light on how best to partner with nurses to improve antibiotic use.”

Opinions expressed in this article are not necessarily those of bioMérieux, Inc.

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