Antibiotic resistanceBack to Nursing Essentials Crib Cards
Antimicrobial resistance occurs when micro-organisms (bacteria, viruses, fungi and parasites) render the antimicrobial medication useless. Resistance to antibiotics by bacteria (antibiotic resistance) is a major concern.
- the prevention of infection is essential to avoiding the need for antibiotics in all care settings
- good hand hygiene helps to prevent infections
- encourage vaccination to prevent infection
- antibiotics do not work for viral infections (colds and flu)
- always ensure that prescribers follow local antibiotic prescribing guidelines.
The importance of specimens
The quality of specimens obtained from patients affects patient management and the likelihood of successful treatment.
- before starting antibiotics, always try to take appropriate specimens and ensure pus is drained or foreign bodies removed as appropriate
- ensure specimens are not taken from non-sterile sites such as urinary catheters or leg ulcers, without clinical evidence of infection
- ensure specimens are stored appropriately and reach the laboratory as soon as possible to avoid specimen degradation and quicken processing.
Key prescribing and administration practice points for the nursing team:
- Seek urgent medical review for suspected sepsis or septic shock with first dose of antibiotics administered within 1 hour of diagnosis.
- Check the following are included on patient’s prescription. If any of these are missing, contact the prescriber to amend the prescription.
- Clinical indication for antibiotic.
- Duration or review date.
- Allergy status including type of reaction.
- Prioritise timely administration of antibiotics, particularly those by IV route. Ensure missed doses are given as soon as possible, as omitting a dose can lead to treatment failure.
- Prompt a review of the patient and laboratory results before 72 hours and ensure an antibiotic plan is documented in the notes and a stop date on the prescription.
- Highlight when patients are eligible for switch from IV to oral antibiotics as soon as possible.
- Highlight if an antibiotic prescription has continued beyond the duration stated in local antibiotic guidelines without appropriate explanation on the patients’ prescription or in medical notes.
Reference: NHS England (2015) Patient safety alert addressing AMR through implementation of an antimicrobial stewardship programme.