Skip to main content

Table 3 Characteristics of antimicrobial stewardship nursing models

From: Nurse roles in antimicrobial stewardship: lessons from public sectors models of acute care service delivery in the United Kingdom

Domains
Antimicrobial stewardship nursing model Interprofessional working Strategic influence-
Relation with other structures
Clinical outcomes
(What measure of impact? Process?)
Individual identity Funding/
Managerial structures
Setting of practice (hospital, community …) Role components (clinical, educational, quality, policy, managerial)
Vertical
(i.e. nurse consultant)
Yes High strategic influence; focal relation with comparable figures/ roles within own profession (i.e. nurse consultant) or others (i.e. pharmacy consultant); collaboration/leadership across aligned areas (i.e. AMS & IPC/AMS & sepsis etc) May be difficult to robustly attribute impact or clinical improvements to the role in view of indirect work (i.e. influencing others)
Feasible to attribute process improvements
Novel professional figure/role, supported by similar professionals in other clinical areas, or professionals from other disciplines Mainstream human resources funding
May be difficult to evaluate value-for-money
Appointed by board-level managers from own or other professions
Hospital or community, but most likely hospital All, with emphasis on planning/ evaluation/
management of organisational practice
Hybrid
(i.e. nurse specialist)
Yes Some strategic influence as part of specialist services; advisory relation with own and other professions across multiple areas Easy to attribute impact or clinical improvements due to focus on planning and delivery of clinical services, education. Traditional role with some expanded or novel skills/ responsibilities which may have been jurisdiction of other professionals or disciplines Funding may be short-term or pilot before substantive, based on results.
Appointed by manager or lead of specialist team, which may not be a nurse (i.e. consultant pharmacist or physician in AMS)
Hospital or community All, with mixture of planning, evaluation and delivery of services
Horizontal
(i.e. staff nurse)
No Limited or minimal strategic influence; most relations within own ward/team, with frequent contact with specialist/advisory roles (i.e. IPC specialists) Feasible to attribute impact or clinical improvements in antimicrobial stewardship interventions deployed Traditional role, supported by similar professionals in same or other clinicals areas Mainstream human resources funding.
Appointed by ward manager/nurse in charge
Hospital or community Mainly clinical, educational, quality and managerial service delivery