Original Research
Nurse Practitioners' Attitudes, Perceptions, and Knowledge About Antimicrobial Stewardship

https://doi.org/10.1016/j.nurpra.2012.01.023Get rights and content

Abstract

Background

Antimicrobial resistance is an urgent public health problem. There is very limited information regarding nurse practitioners' attitudes, perceptions, and knowledge about antibiotic use and resistance.

Methods

Web-based anonymous survey in a university-affiliated hospital.

Results

Most respondents agreed that antimicrobial resistance is a problem locally and nationally, were concerned about resistance in the community when prescribing antibiotics, and agreed that more appropriate use of antibiotics would decrease resistance. There is a paucity of knowledge in the management of anaerobic infections and resistant gram-negative bacteremia.

Conclusion

Incorporating nurse practitioners into antimicrobial stewardship programs could improve evidence-based practices and antimicrobial use.

Section snippets

Methods

In collaboration with the Centers for Disease Control and Prevention's (CDC) Division of Healthcare Quality Promotion “Get Smart about Healthcare,” a 68-item Web-based survey, was developed for use at a 1,500-bed tertiary care center, university-affiliated hospital in Florida. In this setting, NPs collaborate with attending physicians in patient care but have autonomous ability to prescribe antimicrobial therapy. A modified version of the survey instrument that had been distributed to

Demographics

Forty-three percent (58/135) of the NPs completed the questionnaire. The respondents were 88% female; 66% had graduated in their area of specialty as an NP 7 or more years ago, 24% 2-6 years ago, and 10% within 1 year before taking the survey. Among the 58 respondents, 53% reported that they usually prescribe antibiotics mostly for hospitalized patients, 34% mostly for outpatients, and 12% for both. Respondents varied widely in their area of specialty: 26% in critical care, 12% obstetrics and

Discussion

Since the 1970s, studies have shown that NPs consistently provide primary care that is similar in quality to physicians and that NPs have the ability to appropriately prescribe drugs independently.20 NPs' antimicrobial prescribing patterns (both appropriate and inappropriate) for viral infections have been shown to be similar to those of physicians according to some17, 21 but not all22 authors. Roumie et al22 compared outpatient antibiotic prescribing patterns by physicians, nonphysician

Acknowledgments

The authors appreciate the assistance of Ronda Sinkowitz-Cochran, MPH, and Arjun Srinivasan, MD, at the Centers for Disease Control and Prevention, Division of Healthcare Quality and Promotion, for their thoughtful review of the survey and the final manuscript.

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    In compliance with national ethical guidelines, the authors report no relationships with business or industry that would pose a conflict of interest..

    1

    Lilian Abbo, MD, is an assistant professor of clinical medicine in the division of infectious diseases at the University of Miami Miller School of Medicine and medical director of the Antimicrobial Stewardship Program at Jackson Memorial Hospital in Miami, FL.

    2

    Laura Smith, PharmD, BCPS, is a clinical pharmacist in infectious diseases at the same hospital and pharmacy director of the Antimicrobial Stewardship Program.

    3

    Margaret Pereyra, DrPH, is a research assistant professor in the University of Miami department of epidemiology and public health.

    4

    Mary Wyckoff, ARNP, is an acute care nurse practitioner and director of education and research in critical care at the William Lehman Injury Research Center and an assistant professor in the University of Miami School of Nursing.

    5

    Thomas M. Hooton, MD, is professor of clinical medicine in the department of medicine and medical director of infection control and occupational health at the University of Miami.

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