Key messages for nurses

Tasks

1.    You are in a key position to improve antibiotic use by collaborating with the antibiotic stewardship team [96].

2.    Your tasks related to improving antibiotic use include [31,96,97] [expert consensus]:
a)    Administering antibiotics to patients according to the prescription;
b)    Coordinating the taking and sending of microbiological specimens, and their reporting back to physicians;
c)    Reporting adverse effects of antibiotic therapy to physicians and appropriate review committees;
d)    Facilitating communication between physicians, the pharmacy, the laboratory, discharge planners, consultants and patients;
e)    Providing information on treatments to patients and families; 
f)    Monitoring patient status on a 24 hour basis; and
g)    Managing antibiotic stocks on your ward, and ensuring the traceability of antibiotic use [expert consensus].

Things you can do, or collaborate on

3.    Improve antibiotic administration practices in collaboration with doctors and pharmacists [96,97].

4.    Follow infection prevention and control measures that are established in your setting [expert consensus].

5.    Ensure that patients (and their families) understand the reason for antibiotic therapy, and key points related to antibiotic use, including to [31,69] [expert consensus]: 
e)    Take antibiotics exactly as prescribed; 
f)    Never save antibiotics for later use;
g)    Never use leftover antibiotics from previous treatments; and
h)    Never share leftover antibiotics with other people.

6.    Ensure that cultures are appropriately taken and send to the microbiology laboratory, before starting antibiotics [31,42,70]. 

7.    Ensure that laboratory results are promptly communicated to the treating physician [expert consensus].

8.    Prompt prescribers to document their reviewing decision for all patients on antibiotics after 48-72 hours [31,42,69].

9.    Inform the prescriber or pharmacist if you see a patient has an antibiotic prescription which has continued beyond seven days without specified duration [69].

10.    If you see staff members at the hospital or healthcare setting who breach guidelines or protocols, ask them why they are doing so and provide them with tools to understand what they are doing wrong [69] [expert consensus]. 

11.    Participate regularly in training courses and meetings on prudent antibiotic use, specimen collection, and infection prevention and control [53,96].