Mrs Oyegoke, a nursing perspective

I am Joke Okusanya, a member of the Antimicrobial Stewardship Team. I would like to ask you some questions and then within a few minutes we’ll be through. OK. Please, can you tell us your name, your designation and your place of work. I’m Mrs. A.O. Oyegoke, Head of Department, Director of Nursing Services, Lagos University Teaching Hospital. What do you understand by Antimicrobial Stewardship Programme? OK. I can simply define it as coordinated plan and strategy put in place to bring about improvements in the appropriate use of antimicrobial agents to optimise the clinical outcome and reduce antimicrobial resistance. What are the goals and principles of this antimicrobial stewardship?

They are simply to improve patient outcome and safety, to reduce side effects of antibiotics, to reduce antibiotic resistance, as well as also to reduce the costs of use of antibiotics put on patients and institutes. What are the responsibilities of nurses in antimicrobial stewardship? OK. Nurses have a lot of responsibilities. Generally, the nurses that get familiar with and maintain appropriate infection control practices to prevent the occurrence and spread of infection, appropriate placement of patients depending on the required infection prevention measures.

And as well, for the nursing staff, in addition to the above, we have the timely ordering of prescribed antibiotics from the pharmacy, timely administration of medication, proper documentation of the dose and the time, monitoring the effects effectively and the adverse effects, then ensuring specimens are collected before the start of the antibiotic therapy. Then, when we also look at the nurse in charge of the ward, he has a lot of responsibility because he’s a leader, maintaining the adequate hygiene consistent with all the hospital policies and good nursing practice on the ward. Then, she is also supposed to monitor the infection control practices and ensure compliance, because this is very paramount.

Then reporting promptly to the managing team any sign of infection noticed in patients under their care. Then, the senior nurse, she will also participate in the Infection Control Committee activities. Number two is to also promote the development and improvement of nursing techniques, review and update on the aspects of aseptic nursing policies with approval of the Infection Control Committee, then development of training programmes for members of nursing staff for adequate updates, and to ensure adherence to hospital policies by all categories of staff while on the wards and the hospital grand rounds. I see that the responsibilities are to different carers in nursing. Yes. How do you accommodate these antimicrobial stewardship practices within your routine duties? OK.

Many of the activities carried out by the nurses are central to stewardship efforts, such as specimen collection for cultures, timely administration of antibiotics, routine assessment of vital signs, fluid intake and the output. Then, we also look at some of these patients that are on catheters. There must be management of the catheter site and the skin integrity. Also, for those that have wounds, then educational and counselling of patients and relatives, and also communication with doctors, the pharmacies, and the patient information, as well as their conditions. Also, communication amongst all stakeholders in antibiotic delivery puts nurses in a unique vital position to optimise antibiotic use. With all this, do you think there are challenges faced by nurses in actually maintaining duties?

[INAUDIBLE] What they are. Can you mention some of them? Well, there are so many challenges when you talk about manpower, and there is a shortage of manpower. There is a lot that comes in, and then the indigent patient has regards, economic challenges. Some of these patients cannot afford to get these drugs adequately. And then, some other things like carrying out investigations. So there are so many others. Thank you so much. This will be all for today. Thank you so much for coming. Your welcome We appreciate it. Thank you very much.