Education and management of antimicrobials amongst nurses in Africa-a situation analysis: An Infection Control Africa Network (ICAN)/BSAC online survey

Objectives: To assess the current involvement of nurses in the use and management of antimicrobials and their training in antimicrobial stewardship (AMS) across Africa. Methods: After a pilot study, an online questionnaire (SurveyMonkey) in both French and English was circulated via the Infection Control Africa Network (ICAN) mailing list to both members and non-members in Africa. The study was conducted from 26 May to 19 August 2016. Data were summarized in proportions and bar charts; proportions were compared using the X 2 test. A multivariate logistic regression model was built to identify independent factors associated with the practice of AMS. Results: While 96% of the 173 respondents were aware of the term 'AMS', 88.5% (146/165) undertook AMS tasks as part of their job; 91.9% (158/172) wanted to be more involved in AMS but 44.9%(71/158) reported there were barriers in doing so. AMS training was delivered to 36.7% (62/169) and 53.6%(90/168), respectively, during their undergraduate and postgraduate education. AMS training for healthcare workers in their institutions was reported by 50.3% (86/171), including training aimed at doctors (56.9%), pharmacists (76.7%), microbiologists (31.4%) and nurses (95.3%). However, 95.4% (164/172) of respondents asked for further education on AMS and the majority preferred AMS training to be part of the infection prevention curriculum (IPC) education. Threequarters of institutions had an AMS initiative, but only~41% reported having seen a national AMS guideline. Conclusions: For Africa, we recommend AMS education at undergraduate level, AMS policies at institution and national levels and incorporating AMS training into the IPC for nurses.