Understanding Paediatric Nurses' Integration of the National Infection Prevention Standard into Practice

Introduction: Antimicrobial Stewardship (AMS) is a comprehensive approach to ensuring appropriate and safe antimicrobial treatment for patients. While nurses' contribution to infection prevention and control (IPC) is well recognised, their involvement in AMS initiatives remains under-recognised. The aim of this qualitative exploratory descriptive study was to understand how paediatric nurses were incorporating the national preventing and controlling infection standard into their practice. Methods: Forty-three nurses were recruited from adolescent, oncology, and surgical wards in a metropolitan tertiary children’s hospital. Focus group data were analysed using thematic analysis. Results: Three major themes were derived from the data: Understanding of preventable infections, Embracing evidence-based guidelines to protect the patient, and Roles in preventing and controlling infections and antimicrobial stewardship. Nurses had a thorough understanding of IPC practices and clinical guidelines, including sepsis recognition and response, medication adverse reactions, and microbe testing. Nurses showed a limited view of their role in AMS, preferring to focus solely on safe antimicrobial administration. Barriers identified by participants to the implementation of guidelines included parents’ dismissal of the importance of adhering to COVID-19 precautions and that the use of electronic medical records (EMR) for prescribing made it challenging to change the practice environment. Conclusion: Paediatric nurses prioritised good IPC practice however they observed following the lifting of COVID-19 restrictions that parents and visitors no longer prioritised transmission-based precautions when visiting vulnerable patients. Optimising existing EMR systems to further support the nurses’ role in AMS could also help to reduce medication errors and improve patient care.