■本研究旨在基于能力调查中国护士抗菌药物管理(AMS)参与度及其影响因素,机会,动机,和行为(COM-B)理论,为制定有效策略提高AMS护理质量提供有价值的见解。
■这项横断面研究是在湖南17家三级医院进行的,中国,从2021年11月到2022年1月。总共选择了4,514名护士。护士AMS敬业度问卷(NAEQ),使用COM-B理论开发,用于评估。问卷包括能力(14个项目),机会(7项),动机(6项),和行为(12项)四个维度,39项。
■总NAEQ评分为155.08±27.12,表明处于中等水平。能力的得分,机会,动机,行为维度分别为52.33±13.48、28.64±5.76、24.57±4.57和49.53±8.83。护士AMS参与度的显著差异是基于职称,是否作为兼职感染控制护士,是否了解AMS团队和确定的抗生素每日剂量,部门类型,临床药师的部署,抗菌培训和医师-护士联合查房的频率(P<0.05)。初级职称护士的NAEQ得分高于中级职称护士(P<0.05)。兼职感染控制护士,认识AMS团队,定义的日剂量抗生素的NAEQ评分高于未使用抗生素的NAEQ评分(P<0.01)。在ICU和传染病科工作的护士的NAEQ分数低于其他科室,比如耳朵,鼻子,喉部(耳鼻喉科)(P<0.01)。科室有临床药师部署的护士NAEQ评分高于无部署或不明确部署的护士(P<0.01)。此外,接受更频繁的抗菌药物培训并参加医师-护士联合查房的护士的NAEQ评分更高(P<0.01).
■多种策略,包括加强教育和培训,改善多学科沟通和合作,预计将提高护士AMS的参与度。重视中级职称护士,经验少,以及在特定部门工作的人。
UNASSIGNED: This study aimed to investigate the level and influencing factors of nurses\' antimicrobial stewardship (AMS) engagement in
China based on the capability, opportunity, motivation, and behavior (COM-B) theory, providing valuable insights for developing effective strategies to improve nursing quality in AMS.
UNASSIGNED: This cross-sectional study was conducted in 17 tertiary hospitals in Hunan,
China, from November 2021 to January 2022. A total of 4,514 nurses were selected. The Nurse AMS Engagement Questionnaire (NAEQ), developed using the COM-B theory, was used for evaluation. The questionnaire included capability (14 items), opportunity (7 items), motivation (6 items), and behavior (12 items) four dimensions, 39 items.
UNASSIGNED: The total NAEQ score was 155.08 ± 27.12, indicating a moderate level. The score of the capability, opportunity, motivation, and behavior dimensions were 52.33 ± 13.48, 28.64 ± 5.76, 24.57 ± 4.57 and 49.53 ± 8.83, respectively. Significant differences in nurses\' AMS engagement were based on professional titles, whether working as a part-time infection control nurse, whether knowing the AMS teams and the defined daily doses of antibiotics, department type, the deployment of clinical pharmacists, and frequency of antimicrobial training and physician-nurse joint rounds (P < 0.05). Nurses with junior titles had higher scores on the NAEQ than nurses with intermediate titles (P < 0.05). Nurses who worked as part-time infection control nurses, knew the AMS team, and the defined daily doses of antibiotics had higher NAEQ scores than those who didn\'t (P < 0.01). Nurses working in the ICU and infectious disease department had lower NAEQ scores than those in other departments, such as the ear, nose, and throat (ENT) department (P < 0.01). Nurses who had clinical pharmacists deployed in their department had higher NAEQ scores than those without or unclear deployment (P < 0.01). Furthermore, nurses who received more frequent antimicrobial training and participated in physician-nurse joint rounds had higher NAEQ scores (P < 0.01).
UNASSIGNED: Multiple strategies, including enhanced education and training and improved multidisciplinary communication and collaboration, are expected to improve nurse AMS engagement. It is important to give more attention to nurses with intermediate professional titles, less experience, and those working in specific departments.