Antimicrobial resistance (AMR) is a pressing global health challenge, driving the need for effective antimicrobial stewardship (AMS) programmes. Despite nurses’ critical role in care delivery, their involvement in AMS remains under-recognized. Objectives: This mapping review aims to identify barriers and facilitators influencing nurses’ engagement in AMS programmes and examine nursing-sensitive outcomes associated with their participation, using Irvine’s Nursing Role Effectiveness Model (NREM) as a guiding framework. Methods: A systematic mapping review was conducted following Joanna Briggs Institute (JBI) guidance and reported using the PRISMA-ScR checklist. The protocol was registered on the Open Science Framework. Searches were conducted in MEDLINE, CI-NAHL, Scopus, LILACS, Scielo, and grey literature sources. Data were extracted and categorized according to the NREM domains: structure, process, and outcomes. Results: Thirty-two studies were included. Key barriers included limited AMS knowledge, role ambiguity, hierarchical dynamics, communication gaps, and lack of standardized nursing outcomes. Facilitators encompassed targeted AMS education, participation in multidisciplinary discussions, managerial support, and defined nursing roles. Nurse-led interventions showed potential to improve infection control and antibiotic administration, although standardized outcome reporting remains scarce. Conclusions: Framed by the NREM, this review underscores the essential contribution of nurses to AMS. Addressing structural barriers, enhancing role clarity, and fostering interdisciplinary collaboration are critical to enabling nurses’ full participation. Strengthening nursing engagement in AMS not only supports effective antimicrobial use and patient safety but also reinforces health system resilience and sustainability.
Blood culture is crucial for accurate and timely bacteremia diagnosis and guide antibiotic therapy. However, during culture sampling, contamination can occur, resulting in misdiagnosis, unnecessary antibiotic exposure, and prolonged hospitalization. This before-and-after intervention study aimed to evaluate the effectiveness of a multimodal intervention in preventing blood culture contamination. The study was conducted in a 170-bed hospital in Portugal and included a total of 23,566 blood cultures. Contamination rates were assessed in two phases: Phase 1 (before intervention, month 0) included 10,928 cultures, and Phase 2 (after intervention, month 6) included 12,638 cultures. During the study period, a multimodal intervention targeting the nursing staff was implemented, consisting of training actions, guideline updates, regular data monitoring and feedback, and introduction of a blood culture pack. Following the intervention, blood culture contamination decreased from 6.8% (Phase 1) to 3.9% (Phase 2). A comparative analysis revealed that the risk of contamination before the intervention was nearly four times higher in first culture, OR = 3.97 (CI 2.86–5.49). Our findings suggest that the multimodal intervention enhanced nurses’ adherence to recommended practices, resulting in a reduced risk of blood culture contamination, earlier identification of infectious agents, and improved accuracy of antibiotic therapy.
Background: Healthcare-associated infections surveillance is a cornerstone of infection prevention and control, essential for guiding effective program implementation. Timely and clear dissemination of surveillance data is critical to inform decision-making and improve clinical practice. However, traditional lengthy reports are often overlooked due to time constraints among healthcare professionals. To address this, a secondary hospital introduced infographics as a concise and visually engaging method to communicate healthcare-associated infections surveillance data, aiming to enhance feedback and promote more impactful communication. This study explores infection prevention and control link nurses’ perspectives on using infographics to disseminate healthcare-associated infections surveillance data. Methodology: A descriptive qualitative design was employed, using semi-structured individual interviews conducted with thirteen purposively selected participants. Narrative data were analyzed using Bardin’s content analysis methodology. Results: Three key themes emerged as follows: Data awareness; infographic use; and team engagement. Participants emphasized that infographics simplified complex data, improved accessibility, and fostered team engagement. When integrated into educational and clinical workflows, infographics were perceived as effective tools for promoting reflection and supporting a culture of continuous quality improvement. Conclusions: Our findings suggest that infographics offer a promising approach to enhance communication of surveillance data. Their use may support informed decision-making and contribute to improved infection prevention and control practices.