Incorporating Nurses into Antimicrobial Stewardship Practices

Rita Olans, DNP, CPNP-PC, APRN-BC, assistant professor at MGH Institute of Health Professions, discusses how Infectious Disease (ID) specialists, pharmacists, and nurses can work together on antimicrobial stewardship.

Interview Transcript (slightly modified for readability)

“Physicians are highly respected by nurses, and yet, sometimes they can be intimidating. I think pharmacists sometimes are easier to talk to, that’s what my research has shown. I believe that both ID specialists and pharmacists can do a great job in bringing nurses on-board, and by including them in teaching.

There are simple ways I’ve been piloting. One is, to have an inclusive grand rounds with physicians and nurses, all getting the stewardship message at the same time. I’m hoping this fall to collaborate with an ID specialist and to give a combined physician-nurse grand rounds, on stewardship, at a community hospital. Physicians can also help nurses by reinforcing the life cycle of the laboratory, when lab results are coming back, and encourage nurses to be asking all physicians ‘Is this the time to decrease the antibiotics we initially ordered, since we have culture results back?’ Asking nurses to call a huddle or a time-out with the physicians can help bring about better de-escalation.

[It would be great if] pharmacists could help nurses learn how to do a really good allergy history. I have been informally serving my colleagues, and we don’t teach [allergy history] well in nursing programs. Most people have learned on-the-job, how to take an allergy history, and it’s oftentimes not complete. If we could get our physicians and pharmacists to help educate nurses, that would be great. One thing I would caution, though, is to not present this as another job for nurses, because nurses are already doing much of this work. They may not be doing it perfectly, but they could learn how to do it better with some coaching from our ID community.”