Factors influencing antibiotic prescribing by nurse practitioners: A quantitative pilot study using the theory of planned behavior.

BACKGROUND: The overuse of antibiotics contributes to the development of antibiotic resistance (AR) and exposes patients to potential antibiotic-related harm. Nurse practitioners (NPs) are well positioned to optimize antibiotic use; however, little is known about the factors influencing NP prescribing behaviors. PURPOSE: Describe the knowledge, attitude, subjective norms, and perceived behavioral control in prescribing antibiotics among NPs practicing at a large university-affiliated health care system in the northeast United States. METHODOLOGY: This was a cross-sectional online anonymous survey using the Theory of Planned Behavior. Descriptive statistics were used to describe the sample. Nonparametric tests were used to examine differences in the dependent variables by demographic characteristics. RESULTS: One hundred seventy-four of 618 NPs (28%) completed the survey. Almost all considered AR a problem in the United States, but only half considered it a problem in their health care setting. More than half indicated they prescribed antibiotics less than 25% of the time in daily practice. Most were confident in making antibiotic prescribing decisions. There was a positive relationship between years of experience as NPs and their confidence in making antibiotic prescribing decisions ( p < .003) and an inverse relationship between years of experience as NPs and asking for advice from physicians or pharmacists when prescribing antibiotics ( p < .002). CONCLUSION/IMPLICATIONS: With increasing numbers of NPs managing infectious diseases and prescribing antibiotics, these findings will inform interventions to support appropriate prescribing behaviors.

A novel framework to guide antibiotic stewardship nursing practice.

BACKGROUND: There is a pervasive view among some nurses and health care disciplines that antibiotic stewardship (AS) is solely a physician or pharmacist responsibility. There is an urgent need to alter this view so that nurses can seize every opportunity to prevent patient harm from antibiotics and optimize antibiotic use. One challenge to achieving full nurse engagement as equal members of the AS team is lack of an organizing framework to illustrate relationships of phenomena and concepts inherent to adoption of AS nursing practices. METHODS: We sought to create a framework derived from the peer-reviewed literature, systematic and scoping reviews, and professional standards, consensus statements and white papers. The emerging framework went through multiple iterations as it was vetted with nurse clinicians, scholars and educators, physicians, pharmacists, infection preventionists and AS subject matter experts. RESULTS: Our evidence-based Antibiotic Stewardship Nursing Practice SCAN-P Framework provides the much-needed context and clarity to help guide local-level nurses to participate in and lead AS nursing practice. CONCLUSIONS: Nurses worldwide are ideally situated to provide holistic person-centered care, advocate for judicious use of antibiotics to minimize antibiotic resistance, and be AS educators of their patients, communities and the general public. The Antibiotic Stewardship Nursing Practice SCAN-P Framework provides a tool to do so.

Advancing Antibiotic Stewardship Nursing Practice Through Standardized Education: A Pilot Study.

Background Antibiotic resistance is a leading global public health threat. Nurses are well positioned to optimize antibiotic use via targeted antibiotic stewardship (AS) nursing practices. However, standardized AS education for nurses is lacking. The objective of this study was to evaluate the effect of an online AS for nurses continuing education program on nurses' antibiotic resistance, antibiotic, and AS knowledge and their intent to integrate AS into their clinical practice. Method A quasi-experiential pretest-posttest design was used with a convenience sample of nurses at a U.S. academic medical center. Focus groups were conducted with those completing the program. Results Forty-seven of 100 eligible nurses completed the program and the pre- and posttest surveys. Participation resulted in statistically significant increases (p < .05) in antibiotic resistance, antibiotic, and AS knowledge, confidence, and perceptions related to the role of nursing in AS. Focus group participants had multiple recommendations for ways to integrate AS in daily nursing practice. Conclusion Completing a comprehensive AS nursing continuing education program could prove instrumental to motivating nurses to adopt AS nursing practices. [J Contin Educ Nurs. 2022;53(9):417-423.].

Analysis of blood type for SARS-CoV-2 and correlation for disease acquisition in various sociodemographic groups including women of childbearing age.

BACKGROUND: Multiple studies have occurred to determine if a patient's blood type, Rhesus factor (Rh), and sociodemographic attributes contribute to contracting SARS-CoV-2. True association remains unknown. METHODS: Inclusion criteria included in-patients who were tested for SARS-CoV-2 with blood type assessed. Study endpoints combined ABO, Rh and all-cause inpatient mortality (ACIM) with testing positivity. Pregnancy status was one of several secondary endpoints evaluated. A logistic regression analysis was used to estimate association. RESULTS: Of the 27,662 patients who met inclusion criteria, Type A blood was associated with increased positivity [1.01 (1.0-1.21), P = .03]. Type B [1.10 (0.99-1.23), P = .08] and AB [0.98 (0.81-1.19), P = .84] showed no association. When evaluating ACIM, type A [1.18 (0.91-1.52), P = .22], B [1.13 (0.82- 1.56), P = .480], and AB [1.06 (0.62-1.81), P = .839] were not associated with increased mortality. The female subgroup was less likely to test positive [0.88 (0.82-0.986), P = .002]. Black patients demonstrated a higher likelihood of positivity when compared to White [1.96 (1.79-2.14), P < .001]. Non-pregnant women exhibited a 2.5 times greater likelihood of testing positive [2.49 (2.04-3.04), P < .001]. CONCLUSIONS: This study confirms results of previous research which showed SARS-Co-V-2 positivity related to blood type. It also confirms more recent research demonstrating inequities related to acquisition of SARS-CoV-2 for certain sociodemographic groups. Larger studies are warranted to confirm and further explore novel pregnancy findings.