Empowering nurses for effective diagnostic stewardship: An initiative to address anti-microbial resistance

This study aimed to evaluate nurses' baseline understanding of diagnostic stewardship (DS) principles and the impact of an educational intervention on their knowledge and practices. Antimicrobial resistance (AMR), driven by inappropriate antibiotic use, is a critical global health threat. Effective antimicrobial stewardship (AMS) requires integrating DS to ensure accurate diagnoses through proper test requisition, specimen handling and timely reporting. However, understanding and implementation of DS remains poor in general, contributing to inappropriate antibiotic use. Nurses play a crucial role in DS, yet their potential is underused, highlighting the need for targeted educational interventions. A quasi-experimental pre-post study conducted from September 2022 to March 2023. A gap analysis assessed nurses' baseline knowledge of DS informing the development of an online training program. In the intervention phase, pre-and post-assessments measured knowledge improvements after the intervention. In phase 1, 310 out of 517 nurses completed the gap analysis, with an average score of 6.59 out of 20 (range: 2-13; median score: 6.5). In phase 2, 228 of 613 nurses completed both pre- and post-tests, showing a significant improvement in scores from 4.69 (median 5), in pre-test to 6.22 (median 6) in post-test. The educational intervention significantly enhanced nurses' knowledge of AMR, specimen selection, culture indications and collection techniques. Sustained training is vital to strengthen diagnostic practices, reduce inappropriate antimicrobial use and combat AMR.