Ms Fiona Gotterson1,2, Professor Kirsty Buising1,2,3,4, Associate Professor Lisa Hall5, Professor Elizabeth Manias5,6, Dr Arjun Rajkhowa1,2
1Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
2National Centre for Antimicrobial Stewardship, Peter Doherty Institute, Melbournev, Australia
3Victorian Infectious Diseases Service, Royal Melbourne Hospital and the Department of Medicine, University of Melbourne. , Melbourne , Australia
4Faculty of Medicine, The University of Queensland, Herson, Australia
5Deakin University, School of Nursing and Midwifery, Burwood, Australia
6Department of Medicine, Royal Melbourne Hospital, Parkville, Australia
Introduction: Antimicrobials are important medicines, but sometimes misused, which drives antimicrobial resistance (AMR). Antimicrobial stewardship (AMS), an interprofessional activity, aims to reduce harms linked to antimicrobial misuse. Nurses influence antimicrobial use, however understanding of their AMS role is limited. This protocol is for a doctoral study which aims to comprehensively examine the nurse role in AMS across hospital and general practice settings, to show how nurses currently contribute, and ways to formalise and sustain nurses’ active AMS involvement.
Methods: Multiple methods underpinned by implementation and behavioural theory. Phase One; published integrative review. Phase Two comprises two studies, with data analysis for each using established implementation frameworks. First, a qualitative study exploring hospital nurse-led AMS. Second, a sequential mixed methods study, exploring general practice nurses’ AMS contribution. Phase Three; integration and analysis of findings from Phases One and Two, applying Normalisation Process Theory to understand implementation influences relevant to nurses’ role.
Results: Poster details major elements of study design, methods, strengths, and limitations. Available findings will be presented. Researcher experience using theoretically informed, multiple methods design to understand implementation processes and complexities in different contexts will be discussed.
Conclusion: Nurses are critical to patient safety but their AMS role is poorly understood and not formalised. Multiple methods design using implementation theory recognises complexities of nursing practice, and enables comprehensive exploration of nurses AMS role across different contexts. This novel study will give new insight about nurses’ AMS contribution, and inform practice and policy measures to facilitate nurse involvement in this activity.
Biography: Fiona is a registered nurse with extensive experience in health care, in nursing, education, quality improvement, and project management. Currently Fiona is PhD fellow at the National Centre for Antimicrobial Stewardship, University of Melbourne. Her main research interests are nurses and antimicrobial stewardship (AMS), implementation and translation of evidence to practice, and interprofessional collaboration, in healthcare. Before her PhD Fiona held a senior project role at the Australian Commission for Safety and Quality in Healthcare, leading work on the National Antimicrobial Stewardship Project. Fiona has contributed to various publications and presented in several forums on nurses’ and AMS role.