Implementation of a Nurse-Driven Antibiotic Engagement Tool in 3 Hospitals.

Background Nurses are key in implementing antibiotic stewardship; however, standardized processes are lacking. Methods This feasibility study tested implementation of a nurse-driven antibiotic engagement tool (AET) that addressed antibiotic indication, duration, discontinuation, and intravenous to oral conversion. An investigator-developed survey measured nurse satisfaction, confidence, and understanding of antibiotic plan of care among 4 clinical units. Mann-Whitney U was used to compare differences between time periods. Non-parametric summary distributions assessed AET use. Results Results from 121 surveys were available; 71 (36%) pre-survey, 50 (24%) post-survey. Thirteen registered nurses reported satisfaction or agreement with AET use: (a) ease (median: 4 [2.25, 4]); (b) time (median: 4 [3.5, 4.5]); (c) helped facilitate asking questions (median: 4 [3, 4]); (d) helped find antibiotic information (median: 4 [2.5, 4]); and (e) increased confidence in antibiotic discussions (median 4 [3, 4]). Planned duration of antibiotic therapy was unclear to nurses 13.9% of the time with nurses identifying duration discrepancies in 22.8% of submitted AETs. Conclusions The AET promoted interprofessional conversation. Use was higher in settings where leaders and nurse influencers were involved in stewardship promotion. Clarifying antibiotic duration is a prime area for future nursing antibiotic stewardship efforts.