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임상간호사의 항생제 스튜어드십 인식도와 수행도

Clinical Nurses' Perception and Performance of Antimicrobial Stewardship

  • 노보영 (동아대학교병원 간호부) ;
  • 유정옥 (동아대학교 간호학과)
  • Noh, Bo Yeoung (Department of Nursing, Dong-A University Hospital) ;
  • Yu, Jungok (Department of Nursing, Dong-A University)
  • 투고 : 2024.05.29
  • 심사 : 2024.06.19
  • 발행 : 2024.08.31

초록

Purpose: This study aimed to assess the perception and performance of antimicrobial stewardship among clinical nurses and to contribute to establishing their role through an Importance-Performance Analysis(IPA) matrix. Methods: The study included 203 nurses working in hospitals of general hospital level or higher. Data collection took place from April 9 to May 6, 2024. Data analysis involved descriptive statistics, t-tests, ANOVA, Scheffé tests, and IPA analysis. Results: The average perception score for antimicrobial stewardship was 4.42±0.46, while the performance score was 3.96±0.53. Significant differences in perception and performance were observed across several ares: observation of patients, checking with/suggesting to physician based on assessments, implement tests and antimicrobial administration, patient education and support, coordinating multiple disciplines and institutions, acquiring up to date knowledge(p<.050). Perception was highest in the area of implement tests and antimicrobial administration but lowest in coordinating multiple disciplines and institutions. Conclusion: To establish the specific role of nurses in antimicrobial stewardship, improving nurse perception and fostering collaboration with various experts are essential. Developing educational programs and institutional support tailored to nurses is necessary to address areas identified for improvement in both perception and performance.

키워드

과제정보

본 연구는 2024년 동아대학교 교내 연구비를 지원받아 진행한 연구임.

참고문헌

  1. Ventola CL. The antibiotic resistance crisis: Part 1: Causes and threats. Pharmacy and Therapeutics. 2015;40(4):277-283
  2. Savage M, Meade E, Slattery MA, Garvey M. Antibiotic resistance: An important issue for public health safety. Annals of Microbiology and Research. 2017;1(1):26-30. https://doi.org/10.36959/958/566
  3. Kim DS, Lee KU, Oh LL, Lee EJ, Lee DH, Kim SW, et al. Research report on ways to revitalize stewardship programs for appropriate use of antibiotics. Wonju: Health Insurance Review and Assessment Service; 2019 Dec. Report No.: G000F8K-2018-130.
  4. Centers for Disease Control and Prevention(US). Antibiotic resistance threats in the United States, 2013 [Internet]. Atlanta (GA): Department of Health & Human Services, Centers for Disease Control and Prevention; c2013 [cited 2024 July 20]. Available from: https://www.cdc.gov/drugresistance/pdf/ar-threats-2013-508.pdf.
  5. Antimicrobial resistance: Tackling a crisis for the health and wealth of nations: The review on antimicrobial resistance chaired by Jim O'Neill [Internet]. London: Review on Antimicrobial Resistance; c2014 [cited 2024 July 20]. Available from: https://wellcomecollection.org/works/rdpck35v.
  6. de Kraker ME, Stewardson AJ, Harbarth S. Will 10 million people die a year due to antimicrobial resistance by 2050? PLoS Medicine. 2016;13(11):e1002184. https://doi.org/10.1371/journal.pmed.1002184
  7. Kim DS, Lee DH. Current status of pharmaceutical use in Korea according to OECD statistics. HIRA Policy Trends. 2018;12(4):33-44.
  8. Ministry of Health and Welfare. Antibiotic and injection prescription rates [Internet]. Daejeon: e-Country Indicators; c2021 [cited 2024 July 20]. Available from: https://www.index.go.kr/unity/potal/main/EachDtlPage Detail.do?idx_cd=1449.
  9. Korea Disease Control and Prevention Agency. Antibiotic usage/resistance rate [Internet]. Cheongju: One Health Antimicrobial Resistant Organism; c2021 [cited 2024 July 20]. Available from: https://nih.go.kr/nohas/statistics/selectAURStatistics.do.
  10. World Health Organization. Antimicrobial resistance [Internet]. Geneve(CH): World Health Organization; c2021 Nov [cited 2024 July 20]. Available from: https://www.who.int/es/news-room/fact-sheets/detail/antimicrobial-resistance.
  11. Dellit TH, Owens RC, McGowan JE, Gerding DN, Weinstein RA, Burke JP, et al. Infectious diseases society of America and the society for healthcare epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clinical Infectious Diseases. 2007;44 (2):159-177. https://doi.org/10.1086/510393
  12. Drew RH. Antimicrobial stewardship programs: How to start and steer a successful program. Journal of Managed Care Pharmacy. 2009;15(2 Suppl):S18-S23. https://doi.org/10.18553/jmcp.2009.15.s2.18
  13. Ruiz J, Ramirez P, Gordon M, Villarreal E, Frasque J, Poveda-Andres JL, et al. Antimicrobial stewardship programme in critical care medicine: A prospective interventional study implantacion de un programa de optimizacion de antimicrobianos en el paciente critico: Estudio de intervencion. Medicina Intensiva. 2018;42(5):266-273. https://doi.org/10.1016/j.medin.2017.07.002
  14. Kim DK, Choi MH, Hong JS, Shin JH, Jeong SH. Current status and prospects of the national antimicrobial resistance surveillance system, Kor-GLASS. Korean Journal Healthcare-Associated Infection Control and Prevention. 2022;27(2): 96-103. https://doi.org/10.14192/kjicp.2022.27.2.96
  15. Owens RC, Shorr AF, Deschambeault AL. Antimicrobial stewardship: Shepherding precious resources. American Journal of Health-System Pharmacy. 2009;66(12 Suppl 4):S15-S22. https://doi.org/10.2146/090087c
  16. Sumner S, Forsyth S, Collette-Merril K, Taylor C, Vento T, Veillette J, et al. Antibiotic stewardship: The role of clinical nurses and nurse educators. Nurse Education Today. 2018;60:157-160. https://doi.org/10.1016/j.nedt.2017.10.011
  17. Daniels R. Antimicrobial resistance: We need better stewardship in all sectors. British Journal of Hospital Medicine. 2014;75(10):544-545. https://doi.org/10.12968/hmed.2014.75.10.544
  18. Padigos J, Ritchie S, Lim AG. Enhancing nurses' future role in antimicrobial stewardship. Collegian. 2020;27(5):487-498. https://doi.org/10.1016/j.colegn.2020.01.005
  19. Olans RD, Nicholas PK, Hanley D, DeMaria A. Defining a role for nursing education in staff nurse participation in antimicrobial stewardship. Journal of Continuing Education in Nursing. 2015;46(7):318-321. https://doi.org/10.3928/00220124-20150619-03
  20. Abbas S, Lee K, Pakyz A, Markley D, Cooper K, Vanhoozer G, et al. Knowledge, attitudes, and practices of bedside nursing staff regarding antibiotic stewardship: A cross-sectional study. American Journal of Infection Control. 2019;47(3): 230-233. https://doi.org/10.1016/j.ajic.2018.09.008
  21. Carter EJ, Greendyke WG, Furuya EY, Srinivasan A, Shelley AN, Bothra A, et al. Exploring the nurses' role in antibiotic stewardship: A multisite qualitative study of nurses and infection preventionists. American Journal of Infection Control. 2018;46(5):492-497. https://doi.org/10.1016/j.ajic.2017.12.016
  22. Ha DR, Forte MB, Olans RD, OYong K, Olans RN, Gluckstein DP, et al. A multidisciplinary approach to incorporate bedside nurses into antimicrobial stewardship and infection prevention. Joint Commission Journal on Quality and Patient Safety. 2019;45(9):600-605. https://doi.org/10.1016/j.jcjq.2019.03.003
  23. Ju J, Han K, Ryu J, Cho H. Nurses' attitudes toward antimicrobial stewardship in South Korea. Journal of Hospital Infection. 2022;129:162-170. https://doi.org/10.1016/j.jhin.2022.07.016
  24. Sakaguchi M, Aminaka M, Nishioka M. The roles of bedside nurses in Japan in antimicrobial stewardship. American Journal of Infection Control. 2023;51(1):48-55. https://doi.org/10.1016/j.ajic.2022.02.026
  25. Kwon EH. An analysis of performance and perception of needed nursing by visiting nurses in long-term care insurance for the elderly [master's thesis]. Daejeon: Daejeon University; 2023. p. 1-61.
  26. Jung DG. Factors influencing the involvement of intensive care unit nurses in the antimicrobial stewardship program [master's thesis]. Keimyung University; 2024. p. 1-66.
  27. Nie H, Yue L, Peng H, Zhou J, Li B, Cao Z. Nurses' engagement in antimicrobial stewardship and its influencing factors: A cross-sectional study. International Journal of Nursing Sciences. 2024;11(1):91-98. https://doi.org/10.1016/j.ijnss.2023.12.002
  28. Lalithabai DS, Hababeh MO, Wani TA, Aboshaiqah AE. Knowledge, attitude and beliefs of nurses regarding antibiotic use and prevention of antibiotic resistance. SAGE Open Nursing. 2022;8:23779608221076821. https://doi.org/10.1177/23779608221076821
  29. Kim B, Lee MJ, Moon SM, Park SY, Song KH, Lee H, et al. Current status of antimicrobial stewardship programmes in Korean hospitals: Results of a 2018 nationwide survey. Journal of Hospital Infection. 2020;104(2):172-180. https://doi.org/10.1016/j.jhin.2019.09.003
  30. Rout J, Brysiewicz P. Perceived barriers to the development of the antimicrobial stewardship role of the nurse in intensive care: Views of healthcare professionals. Southern African Journal of Critical Care. 2020;36(1):51-56. https://doi.org/10.7196/sajcc.2020.v36i1.410