Background
Standard 3 of the National Safety and Quality Healthcare Service Standards recommends that the rationale and planned duration of antimicrobial therapy is documented in the patient’s record. This facilitates team communication, supports antimicrobial stewardship and improves patient care. Current compliance is below target.

Objective
This pilot is a novel strategy designed to engage the nursing team to lead antimicrobial stewardship by requesting medical staff to outline an antimicrobial plan when antimicrobial agents are initiated. This is a quality initiative aligned with the National Standards.

Method
An audit (Phase 1) was conducted on the Haematology /Oncology Unit to establish baseline data. Following this, education was provided to the Unit nursing team by the Nursing Educator and antimicrobial stewardship pharmacist to support active nursing intervention for the medical team to document indication and planned duration at the time of initiation of antimicrobial agents.
In Phase 2, when an antimicrobial was prescribed, nursing staff and the clinical ward pharmacist were asked to request that the doctor document both indication and planned duration in the patient’s history. The Project team provided mentoring and support for the nursing team during this phase.
Full support was received from the Unit, and nursing and medical executive prior to commencement.

Results
Feedback for the nursing team and compliance with documentation were reviewed and analysed. These findings will inform the roll out of this initiative across the Health Service.

Conclusion
Awareness of indication and planned duration of antimicrobial therapy is key in managing patients clinically and assists all team members in optimising care. Documentation as required by the National Standards, further facilitates communication between the health professionals who are caring for the patient .The nursing team are well placed to lead antimicrobial stewardship and it can be incorporated as part of standard patient care and advocacy.