Exploring the role of nurses in Antimicrobial Stewardship: barriers, facilitators, and change promotion. A meta-synthesis.

Background: Antimicrobial stewardship comprises targeted actions to promote the appropriate use of antibiotics in healthcare, optimizing patient outcomes and preserving antibiotic efficacy for future use. Despite their crucial role, nurses' involvement in AMS varies due to factors like national policies, existing programs, organizational contexts, and education levels. Aim: This paper aims to evaluate nurses' knowledge of antimicrobial stewardship (AMS) and their perceptions of the barriers and facilitators affecting their participation in stewardship programs. Methology: According the Joanna Briggs Institute (JBI) methodology for qualitative systematic reviews, relevant studies from the past five years were sourced from databases like PubMed, CINAHL, Embase, PsycINFO, and Google Scholar. These studies were appraised using the CASP checklist, and nineteen articles spanning five continents met the inclusion criteria. Results: Analysis of the studies revealed six recurring themes: organization of AMS programs, context and resources, training and education, communication and relationships, antibiotic usage, and the role of nurses. These themes reflect the experiences and opinions of nurses involved in AMS programs. Discussion: Nurses at all levels are pivotal to the success of antimicrobial stewardship. While there is global interest in the active engagement of nurses in AMS, more research, particularly qualitative and in non-hospital settings, is necessary to understand and enhance their involvement better.