Antimicrobial Stewardship: The Role of Nurses in Preventing DrugResistance among Patients in Government-Owned Hospitals in CrossRiver State, Nigeria

Abstract

Antimicrobial resistance (AMR) has become a major global public health threat, undermining the effective treatment of infectious diseases and increasing morbidity, mortality, and healthcare costs. Nurses, as the largest segment of the healthcare workforce in government-owned hospitals, are critical to antimicrobial stewardship (AMS) due to their continuous patient contact, medication administration responsibilities, and role in patient education. This study examined the knowledge, practices, involvement, and challenges of nurses in antimicrobial stewardship and their contribution to preventing drug resistance among patients in government-owned hospitals in Cross River State, Nigeria. A descriptive survey design was adopted, with the population comprising 159 registered nurses. A structured questionnaire was used for data collection, and the responses were analyzed using descriptive statistics (mean, standard deviation, percentages) and inferential statistics (Pearson correlation) to test the research hypotheses at a 0.05 significance level. The findings revealed that nurses demonstrated moderate knowledge and practices regarding antimicrobial stewardship, with higher awareness of AMS principles than consistent application in clinical practice. Nurses’ involvement in AMS activities was moderate, with stronger engagement in patient education and infection prevention than in institutional stewardship committees. The study also identified significant challenges, including high workloads, limited access to training, inadequate institutional support, and restricted access to updated clinical guidelines, which negatively affected nurses’ AMS practices. A positive and significant correlation was found between nurses’ knowledge and practices (r = 0.68, p < 0.05) and between involvement and practices (r = 0.63, p < 0.05), while challenges were negatively correlated with AMS practices (r = –0.57, p < 0.05). The study concluded that nurses play a critical role in antimicrobial stewardship and the prevention of drug resistance; however, their potential is limited by systemic, institutional, and educational barriers. Recommendations include targeted training programs, enhanced integration of nurses into AMS committees, improved resource allocation, and interprofessional collaboration to strengthen stewardship practices and reduce antimicrobial resistance in government-owned hospitals