Nurses' Knowledge, Perception, and Self-Confidence Regarding Evidence-Based Antibiotic Use in the Long-Term Care Setting.

OBJECTIVE: Describe knowledge, perceptions, and self-confidence of nurses in the long-term care setting before and after online antibiotic stewardship education, and assess effectiveness and satisfaction with the education.

DESIGN: Pre-/postsurvey.

SETTING: Three long-term care facilities, Topeka, Kansas.

PARTICIPANTS: Convenience sample of 140 licensed practical and registered nurses.

INTERVENTIONS: Nurses viewed a 12-minute online module developed by long-term care consultant pharmacists. The module discussed risks of antibiotic use and the Loeb minimum criteria for initiation of antibiotics in long-term care residents for urinary and respiratory tract infections and explored other conditions contributing to suspicion of these infections.

MAIN OUTCOME MEASURES: Knowledge, perceptions, and self-confidence were measured using a 5-point Likert-scale survey modified from the Minnesota Department of Health taken before and after the module.

RESULTS: Response rate was 45% (63/140) pre-education and 41% (57/140) post-education. Nurses had high baseline self-confidence (mean 4.2 to 4.5/5.0) and pre/post scores did not change significantly. Statistically significant improvements in knowledge and perceptions were seen in 15 of the 33 indices related to assumptions regarding antibiotic use, risks, and indicators of urinary and respiratory bacterial infections. Nurses rated the education as high quality (95%), applicable to practice (95%), and felt very likely to change practice (91%).

CONCLUSIONS: Although baseline self-confidence was high, key misperceptions were identified, indicating that nurses may not be aware of their knowledge deficits or misperceptions. This low-cost, 12-minute, online education was highly valued and effectively improved nurses' knowledge and perceptions.