Factors that influence registered nurse prescribers' antibiotic prescribing practices

Abstract
The rise of antimicrobial resistance is a major global health issue, rendering medications used to treat infections caused by microorganisms as ineffective. This is a significant threat to public health as common infections become untreatable, leading to increases in duration of illness, incidence of disease, cost of treatment, and rises in morbidity and mortality. Inappropriate prescribing of antibiotics is one factor that contributes to antimicrobial resistance. One of the newest groups of prescribers in Aotearoa New Zealand is the Registered Nurse Designated Prescriber (RN prescriber) in primary health and specialty teams, yet little is known about their approach to antibiotic prescribing. This study aims to explore RN prescribers’ antibiotic prescribing practices. A qualitative approach was used with sampling by snowball method. Interviews with six participants were conducted, recorded, transcribed, and thematically analysed. Findings were grouped into two main themes. The first, clinical assessment, had sub-themes identified as clinical indications; testing for infections and other morbidities; consulting resources; and individualising treatment. The second theme, safety considerations, had one sub-theme: first- and second-line antibiotics. Overall, these registered nurses were found to be cautious in their approach to prescribing antibiotics and they were aware of the importance of safe antibiotic prescribing. Limitations of this study included the small sample size. It would be worthwhile repeating this study when more RN prescribers are practising in this role. Additionally, the antibiotic prescribing practices of other prescribing groups should be explored as safe antibiotic prescribing is the responsibility of all prescribers.

Ngā ariā matua
He take nui i te ao hauora puta noa i te ao te ātetetanga ki ngā rongoā patumoroiti, nā te mea mā ēnei āhuatanga ka kahakore ngā rongoā e whakamahia nei hei pēhi i ngā pokenga a tēnei mea te moroiti. Ka noho tēnei hei mōrea mō te hauora tūmatanui inā hoki, mā konei ka uaua te whakatika i ngā pokenga e mōhiotia nuitia ana, mā reira hoki ka takaroaroa te māuiui, ka maha ngā pānga ki te tangata, ka piki hoki te utu ki te whakaora tangata, me ngā pikinga o te taumaha o te mate me te nui o ngā tūroro ka mate rawa i aua māuiui. Ko te tuhi hauwarea i ngā puka rongoā mō te paturopi tētahi pūtake kotahi e whakapiki nei i te ātete a te moroiti ki ngā rongoā. Tētahi o ngā rōpū kaituhi puka rongoā hoa rawa o Aotearoa ko ngā Kaituhi Puka Rongoā Whai Mana Tapuhi Rēhita (RN), engari kāore i te nui te mōhiotanga ki ō rātou whakaaro mō te tuhi puka rongoā paturopi. Tā tēnei rangahau he tūhura i ngā ritenga tuhi puka rongoā a ngā Kaituhi Puka Rongoā Whai Mana Tapuhi Rēhita. I whakamahia tētahi huarahi kounga, ā, ko ngā tīpoka i mahia mā te tikanga whakapāpā tangata. E ono ngā uiuinga ki te hunga whai wāhi i kawea, ā, ka hopukina, ka āta tuhia, ka tātaritia Ngā ariā matua. I waitohutia ētahi ariā matua e rua i roto i ngā kitenga: Ko te Aromātawai Āwhina Tūroro, me ngā ariā o roto o ngā tūtohu āwhina tūroro, te whakamātautau mō ngā pokenga me ētahi atu māuiui, te āta rapu i ngā puna mōhiotanga, me te whakahāngai taurimatanga ki te tangata takitahi, tuarua ko ngā Ritenga Haumarutanga, me tētahi ariā kotahi o roto, ko ngā paturopi kapa tuatahi, kapa tuarua anō hoki. Mō te nuinga, ka kitea ko te tūpato te āhua nui o te tuhi puka rongoā a ēnei tapuhi mō ngā rongoā paturopi, ā, i mārama rātou ki te hira o te tuhi puka rongoā paturopi i runga i te haumaru. Ko tētahi o ngā here o tēnei rangahau ko te tokoiti o te hunga i uia. He mea whai tikanga kia tuaruatia tēnei rangahau, ina maha kē atu ngā kaituhi Puka Rongoā Whai Mana Tapuhi Rēhita, kia maha ake ngā tapuhi whai wāhi. I tua atu i tērā, me rangahau pea ngā ritenga tuhi puka rongoā o ētahi atu rōpū tuhi puka rongoā, nā te mea, mā te katoa te haepapa kua haumaru te tuhi puka rongoā paturopi.

Keywords / Ngā kupu matua
registered nurse prescribers / ngā kaituhi puka rongoā whai mana tapuhi rēhita; antibiotic prescribing practices / ngā ritenga tuhi puka rongoā paturopi; antimicrobial resistance / te ātetetanga moroiti