From Willingness to Action: Evaluating the Role of Nurses in Antimicrobial Stewardship Programs across Three Tertiary Government Hospitals
Fatima MohtashimAbstract
Background:
Antimicrobial resistance is a global health emergency, with antimicrobial stewardship programs (AMSPs) serving as a key strategy to optimize antibiotic use. While stewardship efforts traditionally focus on prescribers and pharmacists, nurses remain under-recognized stakeholders despite their continuous patient contact and critical role in medication administration and infection control.
Objective:
To evaluate nurses’ knowledge, awareness, willingness, and perceived barriers regarding involvement in AMSPs in government hospital settings.
Methodology:
A qualitative interview-based study was conducted among 350 nurses across three government hospitals in Aligarh, India (Jawaharlal Nehru Medical College Hospital, Mohanlal Gautam Rajkiya Mahila Chikitsalaya, and Pt. Deen Dayal Upadhyay Hospital). A structured questionnaire assessed awareness of antimicrobial stewardship, antibiotic resistance knowledge, participation in antibiotic-related practices, and willingness to engage in AMSP activities. Experience-based stratification was performed, and descriptive analysis was used to summarize findings.
Results:
Knowledge regarding antimicrobial stewardship was consistently low across all experience categories, with many nurses unfamiliar with the term “antimicrobial stewardship.” Limited understanding was observed in areas such as culture-before-antibiotic initiation, 48–72-h review protocols, and specimen handling practices. However, willingness to participate was notably high: 97% agreed AMSP should be part of nursing practice, 95% supported formal training, and 91% expressed interest in active participation. Key barriers identified included high workload, limited interprofessional communication, lack of structured training, and absence of electronic medical support systems.
Conclusion:
Despite significant knowledge gaps, nurses demonstrate strong willingness to engage in antimicrobial stewardship initiatives. Structured education, administrative support, and integration into multidisciplinary stewardship frameworks may enhance the effectiveness of AMSPs in resource-constrained public healthcare settings.