Nurses' knowledge and implementation of antimicrobial stewardship and infection prevention strategies in acute paediatric settings.

BACKGROUND: Nurses are the first point of contact for patients and are responsible for monitoring and reporting signs of infection. The COVID-19 pandemic cemented nurses' leadership role in infection prevention. Despite this, nurses' contribution to antimicrobial stewardship initiatives remains under-recognized. AIM: To determine how paediatric nurses understood their role and contribution to antimicrobial stewardship and infection prevention and control practices in three different acute paediatric wards. METHODS: Forty-three nurses were recruited from an adolescent ward, an oncology ward, and a surgical ward in a metropolitan tertiary children's hospital for a qualitative exploratory descriptive study. FINDINGS: Thematic and content analysis derived three themes 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. Associated subthemes were: desensitized to COVID-19; understanding infection prevention and control precautions; correct use of hospital policy and guidelines; restrictions associated with the use of electronic medical records; understanding of sepsis management and the importance of timely microbiological testing; ambivalence on antimicrobial stewardship roles; and high priority placed on consumer education. CONCLUSION: Nurses' understanding of their role focused on practices such as performing hand hygiene, standard precautions, and reporting the use of high-risk antimicrobials. A lack of understanding of paediatric COVID-19 transmission and presentations was also reported. Education on best practice in infection prevention and AMS was recognized as crucial for both nurses and parents.

Towards optimal quarantine: A scoping review of quarantine planning in the pandemic preparedness plans and pandemic exercises of Australia and New Zealand

Introduction: Since 2020, the New Zealand and Australian federal, state and territory governments have used quarantine as a strategic infection control measure to contain the SRS-CoV-2 (COVID-19) virus. However, the quarantine programs of both countries were rapidly operationalised without a clear blueprint for infection prevention. This paper identifies gaps in forecasting the need, and planning, for widespread quarantine within New Zealand's and Australia's Pandemic Preparedness Plans and pandemic exercise reports. Method(s): This paper adhered to the Joanna Briggs Institute (JBI) methodology for scoping reviews. Parliamentary websites and databases (Parlinfo, Pandora) were searched for plans and exercise reports, that were publicly available from 2009 to May 2022. Documents were examined using directive content analysis and assessed on their alignment with the core elements of people, resources, governance, systems, and processes, as addressed in the Australian Disaster Preparedness Framework 2018. Result(s): The degree to which the core elements outlined in the Australian Disaster Preparedness Framework were covered in the documents varies significantly across both New Zealand, and the Australian federal, states and territories. Of the 15 identified plans and 8 exercise reports most did not foresee the need for mandatory, large-scale quarantine of people arriving from interstate or overseas and contemplated voluntary quarantine occurring within people's private residences. Conclusion(s): This paper confirms the need to focus on widespread quarantine as an infection control measure to enhance future pandemic operational preparedness. Further development of quarantine capabilities is required in locations aside from private residences, including at Australia's new purpose-built quarantine facilities.Copyright © 2022