EFFECT OF A TEACHING SESSION ON NURSES' PERCEPTION AND PRACTICE OF THE ANTIBIOTIC STEWARDSHIP PROGRAM

Abstract

Background: Antimicrobial resistance represents a major global public health threat, largely driven by inappropriate and excessive antibiotic use. Antimicrobial stewardship programs aim to optimize antibiotic prescribing and utilization; however, the role of nurses in stewardship activities remains underrecognized, particularly in low- and middle-income countries such as Pakistan. Limited knowledge, confidence, and role clarity among nurses may hinder effective stewardship implementation. Objective: To evaluate the effect of a structured teaching session on nurses’ perceptions and self-reported practices related to antimicrobial stewardship at a tertiary care hospital in Pakistan. Study Design: Quasi-experimental pretest–posttest study. Setting: Inpatient clinical units of Nishtar Hospital. Duration of Study: January to June 2025. Methods: Ninety registered nurses were recruited using non-probability consecutive sampling. Baseline assessment was conducted using a validated, self-administered questionnaire assessing knowledge, perceptions, and practices related to antimicrobial stewardship. Participants then received a structured, interactive teaching session addressing core stewardship principles, nursing roles in antibiotic optimization, monitoring and documentation, interprofessional communication, and case-based scenarios. Post-intervention assessment was performed using the same questionnaire. Data were analyzed using SPSS version 26. Paired t-tests and chi-square tests were applied, with statistical significance set at p < 0.05. Results: The mean age of participants was 29.8 ± 6.4 years, and 72.2% were female. Baseline knowledge and perceptions regarding antimicrobial stewardship were suboptimal. Following the educational intervention, significant improvements were observed across all domains. Agreement regarding active nurse involvement in stewardship increased from 46.7% to 78.9%, while confidence in discussing antibiotic-related issues with physicians improved from 31.1% to 66.7% (p < 0.001). Stewardship-related practices, including monitoring antibiotic side effects, patient education, and utilization of laboratory findings, also demonstrated significant post-intervention improvement (p < 0.001). Major barriers identified included limited decision-making authority, lack of access to stewardship guidelines, and high workload. Conclusion: A structured educational intervention significantly improved nurses’ perceptions and self-reported practices related to antimicrobial stewardship. Regular, targeted stewardship training for nurses may enhance multidisciplinary efforts to combat antimicrobial resistance, particularly in resource-limited healthcare settings.