Guest Editorial
How nurses can contribute to combating antimicrobial resistance in practice, research and global policy

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The threat of antimicrobial resistance

Seemingly the stuff of science fiction, antimicrobial resistance has become a threat to global health, prompting the World Health Organization (WHO) to state “[Antimicrobial resistance] is happening right now in every region of the world and has the potential to affect anyone, of any age, in any country” (WHO, 2014). Antimicrobial resistance develops when microorganisms evolve so that they are no longer susceptible to the medications used to kill them. This is a natural phenomenon which is

Nursing and antimicrobial resistance

While the world begins to act on the global level, the nursing community should act to slow and even reverse the rapidly approaching surge. Only around 1% of the many articles on antimicrobial resistance are within the nursing literature, which is both surprising and alarming, as nurses are the largest group of healthcare professionals that interact with the public (Olans et al., 2016). Nurses contribute to the practice, policy and science of global health and have demonstrated considerable

Prescribing

Nurses are the largest professional group interfacing with many millions of people in many contexts on a daily basis, regardless of individual factors such as age, gender or socioeconomic status. The trend for nurses to obtain prescribing rights has increased along with the pressure to enhance primary health care services, where nurses play a significant role. Furthermore, many advanced nurse practitioners are now front line clinicians for a growing part of the population and one study

Infection control

Many low and middle income countries do not have access to the equipment required to reduce acquired nosocomial infections, as was evident during the recent Ebola outbreak (Salaam-Blyther, 2014). Even in OECD countries, however, where there is access to equipment and global agencies have set up infection control guidelines, best practices are not always met. For example, during the SARS outbreak in Canada there were major issues with the use and appropriateness of N95 masks (Public Health

Research

There have been multiple calls to action regarding antimicrobial resistance research within the medical and health sciences (Huttner et al., 2013). Nurses can contribute here by generating evidence from practice settings and publications, supporting other healthcare colleagues in infection, prevention and control and participating in the development of antimicrobial stewardship programs in healthcare facilities. For example, Redulla (2016) notes that there have been no studies addressing the

Policy and advocacy

Organized nursing needs to bring forth issues to policy and decision makers so that they can manage the projected deadly impact of antimicrobial resistance. Today, many inside and outside the field of healthcare understand antimicrobial resistance theoretically, however there is not enough action to slow its expansion. Governments and decision making bodies need to understand that including nurses in their deliberation is not “nice to do” but a “MUST DO” because of the knowledge and practice

Education

Both nurses and ANPs acknowledge the need for further education regarding prevention, treatment and care (Olans et al., 2015). In resource constrained settings, lack of up-to-date knowledge poses a real threat to patient health. Nurses can seek to overcome this deficit through postgraduate and in-service educational programs run by academic institutions or professional societies.

Through experience, we have learned that even basic knowledge and education is vital; for example, achieving optimal

Conclusion

The central role of nurses in patient care across the continuum, research, education and policy makes it clear that they perform numerous functions critical to the successful operation of antimicrobial stewardship programmes. Nurses can play multiple roles in halting the impending antimicrobial resistance crisis as practitioners of best practices, system surveyors and detectors of early warning signs, public educators and policy partners. In order to make their contribution maximal, they should

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