Strategies for the safe use of antimicrobials by Nursing in the hospital environment: an integrative review
HTML (Português (Brasil))
HTML (Español (España))
EPUB (Português (Brasil))
EPUB (Español (España))
PDF (Português (Brasil))
PDF (Español (España))


Atención de Enfermería;
Administración de Antimicrobianos;
Resistencia Microbiana a Medicamentos;
Resistencia Bacteriana a Fármacos. Nursing Care;
Antimicrobial Management;
Microbial Drug Resistance;
Bacterial Drug Resistance. Cuidados de Enfermagem;
Gestão de Antimicrobianos;
Resistência Microbiana a Medicamentos;
Farmacorresistência Bacteriana.

PlumX Metrics


Objective: to identify the strategies for the safe use of antimicrobials adopted by Nursing in the hospital environment. Method: an integrative review, carried out from June to July 2020, on the LILACS, MEDLINE, CINAHL, and EMBASE databases. Articles from 2015 to June 2020 were selected. For the analysis of the evidence levels, the Grading of Recommendations Assessment, Development and Evaluation was adopted. Results: eight articles were found, distributed in Nursing management and care strategies, related to the safe use of antimicrobials. Discussion: among the main managerial strategies, the role of the educator and the setting up of multidisciplinary monitoring committees stand out; and, among the care strategies, the technical specificities of antimicrobial stewardship. Conclusion: the main Nursing practical strategies found were professional education in the rational use and multidisciplinary monitoring of antimicrobial resistance in the hospital environment. It is believed that the identification of these strategies will contribut...
HTML (Português (Brasil))
HTML (Español (España))
EPUB (Português (Brasil))
EPUB (Español (España))
PDF (Português (Brasil))
PDF (Español (España))


Kabbani S, Palms D, Bartoces M, Stone N, Hicks LA. Outpatient Antibiotic Prescribing for Older Adults in the United States: 2011 to 2014. J amgeriatrsoc [Internet]. 2018[cited 2020 Oct 20];66(10):1998-2002. Available from: doi:

Ferreira VM, Gonzaga LMO, Gonzaga LMC, Batista TB, Moreira ED, Oliveira MVM. Perfil de dispensação de antibióticos nos ambientes ambulatorial e hospitalar em Montes Claros, MG. Rev Unim Científica [Internet]. 2016 [cited 2020 Oct 20];18(1): 56-63. Available from:

World Economic Forum. The Global Risks Report 2019.[Internet]. 14.ed. World Economic Forum. 2019 [cited 2020 Oct 20] Available from:

World Health Organization (WHO). Antimicrobial resistance: global report on surveillance. [Internet]. 2014 [cited 2020 Oct 20] Available from:

O’Neill J. The Review on Antimicrobial Resistance. Tackling Drug-Resistant Infections Globally: Final Report and Recommendations. Reino Unido [Internet]. 2016 [cited 2020 Oct 20] Available from:

Joint Commission International. Padrões de acreditação da Joint Commission International para hospitais. 4. ed. Oakbrook Terrace: JCI, 2011.

Alvim ALS. O enfermeiro no programa de gerenciamento do uso de antimicrobianos: uma revisão integrativa. Rev SOBECC [Internet]. 2019 [cited 2020 nov 05]; 24 (3): 154-60. Available from: doi:

Olans RD, Hausman NB, Olans RN. Nurses and Antimicrobial Stewardship: Past, Present, and Future. Infect dis clin North Am [Internet]. 2020 [cited 2020 Oct 20];34(1):67-82. Available from: doi:

Mendes KDS, Silveira RCCP, Galvão CM. Revisão Integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto ContextoEnferm [Internet].2008 [cited 2020 Oct 20];17(4):758-764. Available from: doi:

Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF. Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. The Lancet [Internet]. 1999 [cited 2020 Oct 20];354(9193):1896-900. Available from: doi:

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med [Internet]. 2009 [cited 2020 Oct 20];6(6):e1000097. Available from:

Galvão TF, Pereira MG. Avaliação da qualidade da evidência de revisões sistemáticas. Epidemiol Serv Saude [Internet]. 2015 [cited 2020 Oct 20];24(1):173-5. Available from:


Brasil. Ministério da Saúde. Secretaria de Ciência, Tecnologia e Insumos Estratégicos. Departamento de Ciência e Tecnologia. Diretrizes metodológicas: sistema GRADE – manual de graduação da qualidade da evidência e força de recomendação para tomada de decisão em saúde. [Internet].2014 [cited 2020 Oct 20] Available from:

Ha DR, Forte MB, Olans RD, OYong K, Olans RN, Gluckstein DP, et al. A Multidisciplinary Approach to Incorporate Bedside Nurses into Antimicrobial Stewardship and Infection Prevention. Joint Commi J Quality Patient Safety [Internet]. 2019 [cited 2020 Oct 21];45(9):600-5. Available from: doi: [included in the review]

Olans RD, Olans RN, Witt DJ. Good Nursing Is Good Antibiotic Stewardship. American J Nurs. [Internet] 2017. [cited 2020 Oct 21];117(8):58-63. Availablefrom: doi:[included in the review

Carter EJ, Greendyke WG, Furuya EY, Srinivasan A, Shelley AN, Bothra A et al. Exploring the nurses' role in antibiotic stewardship: A multisite qualitative study of nurses and infection preventionists. Am J Infect Control [Internet]. 2018 May[cited 2020 Oct 21];46(5):492-497. Available from: doi:[included in the review]

Castro-Sánchez E, Gilchrist M, Ahmad R, Courtenay M, Bosanquet J, Holmes AH. Nurse roles in antimicrobial stewardship: Lessons from public sectors models of acute care service delivery in the United Kingdom. Antimicrob Resist Infect Control [Internet]. 2019 [cited 2020 Oct 21]; 8(162). Available from:

doi:[included in the review]

Jump RLP, Gaur S, Katz MJ, Crnich CJ, Dumyati G, Ashraf MS et al. Template for an Antibiotic Stewardship Policy for Post-Acute and Long-Term Care Settings. J American Medic Direct Association [Internet]. 2017 [cited 2020 Oct 21]; 18(11):913-920. Available from: doi: [included in the review]

Ierano C, Thursky K, Peel T, RajkhowaA, Marshall C, Ayton D. Influences on surgical antimicrobial prophylaxis decision making by surgical craft groups, anaesthetists, pharmacists and nurses in public and private hospitals. PloSONE [Internet]. 2019 [cited 2020 Oct 21];14(11):e0225011. Available from: doi: [included in the review]

Courtenay M, Burnett E, Castro-Sánchez E, MoralezF R, DuToit B, Gallagher R, et al. Preparing nurses for COVID-19 response efforts through involvement in antimicrobial stewardshipprogrammes. Journal of Hospital Infection.[Internet]. 2020 [cited 2020 Oct 21]; 106:176-178. Available from: doi:[included in the review]

Lane MA, Hays AJ, Newland H, Zack JE, Guth RM, Newland JG. Development of an antimicrobial stewardship program in an integrated healthcare system. American J Health-System Pharma [Internet]. 2019[cited 2020 Oct 21]; 76(1): 34-43. Available from: doi:[included in the review]

Sánchez EC, Veny MB, Smith M, Singleton S, Bennett E, Appleton J, et al. European Commission guidelines for the prudent use of antimicrobials in human health: a missed opportunity to embrace nursing participation in stewardship. Clin Microbiol Infect [Internet]. 2018 [cited 2020 Oct 21];24(8):914-915. Available from: doi:

Bernardes A. Contemporary perspectives on leadership and management in nursing. Rev Gaúcha Enferm [Internet]. 2018 [cited 2020 Oct 21];39(1):e2018-0247. Available from: doi:

Felix MAS, Toffolo SR. O enfermeiro nos programas de gerenciamento do uso de antimicrobianos: revisão integrativa. Cogitare Enferm [Internet] 2019 [Cited 2020 oct 21]; 24 (1): e59324. vailable from: doi:

Arnemann CT, Lavich CRP, Terra MG, Mello AL, Raddatz M. Health education and permanent education: actions integrating the educational process of nursing. Rev Baiana Enferm [Internet]. 2018 [cited 2020 Oct 21];32(1):e24719. Available from:


Courtenay M, Lim R, Sanchez EC, Hodson K, Morris G, Rout J, et al. Development of consensus based international antimicrobial stewardship competencies for undergraduate nurse education. J Hosp Infection [Internet]. 2019 [cited 2020 Oct 21];103(3):244-250. Available from:


Falkenberg MB, Mendes TPL, Moraes EP, Souza EM. Educação em saúde e educação na saúde: conceitos e implicações para a saúde coletiva. Ciênc Saúde Colet [Internet]. 2014 [cited 2020 Oct 21];19(3): 847-852. Available from: doi:

Giordani JN, Bisogno SBC, Silva LAA. Nurses' perception of managerial activities in user assistance. Acta Paul Enferm [Internet]. 2012[cited 2020 Oct 21];25(4): 511-516.Available from: Available from:

Sousa JBA, Brandão MJM, Cardoso ALB, Archer ARR, Belfort IKP. Comunicação efetiva como ferramenta de qualidade: Desafio na segurança do paciente. Braz J Hea Rev [internet]. 2020 [cited 2020 Oct 21];3(3): 6467-6479.Available from: doi:

Singer M, Deutschman CS, Seymour CW, Hari MS, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA.[Internet]. 2016 [cited 2020 Oct 21];315(8):801-810. Available from: doi:

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Copyright (c) 2020 Array