title: An online course improves nurses' awareness of their role as antimicrobial stewards in nursing homes.
abstract: BACKGROUND
  To support the role of nurses as active proponents of antimicrobial stewardship in long-term care facilities, we developed an educational intervention consisting of a free online course comprised of 6 interactive modules. Here, we report the effect of the course on the knowledge, beliefs, and attitudes toward antimicrobial stewardship of nurses working in long-term care facilities.
  
  
  METHODS
  We used a paired pre- and postcourse survey instrument to assess nurses' knowledge regarding the care of long-term care facility residents with infections and attitudes and beliefs regarding antimicrobial stewardship.
  
  
  RESULTS
  There were 103 respondents, registered nurses or licensed practical nurses, who completed the pre- and postsurveys. Their mean knowledge scores improved from 75% (precourse) to 86% (postcourse, P <.001). After the course, nurses' agreement that their role influences whether residents receive antimicrobials increased significantly (P <.001).
  
  
  CONCLUSIONS
  The online course improves nurses' knowledge regarding the care of long-term care facility residents with infections and improves their confidence to engage in antimicrobial stewardship activities. Empowering nurses to be antimicrobial stewards may help reduce unnecessary antibiotic use among institutionalized older adults.
authors.affiliation: Geriatric Research Education and Clinical Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH.
authors.forename: Brigid M
authors.initials: BM
authors.lastname: Wilson
authors.affiliation: Teaching and Learning Technologies, Case Western Reserve University, Cleveland, OH.
authors.forename: Sue
authors.initials: S
authors.lastname: Shick
authors.affiliation: Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, OH.
authors.forename: Rebecca R
authors.initials: RR
authors.lastname: Carter
authors.affiliation: Geriatric Research Education and Clinical Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH.
authors.forename: Barbara
authors.initials: B
authors.lastname: Heath
authors.affiliation: Geriatric Research Education and Clinical Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH; Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Higgins
authors.affiliation: Geriatric Research Education and Clinical Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH.
authors.forename: Basia
authors.initials: B
authors.lastname: Sychla
authors.affiliation: School of Nursing, University of Kansas Medical Center, Kansas City, KS.
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Olds
authors.affiliation: Geriatric Research Education and Clinical Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH; Department of Medicine, Division of Infectious Diseases and HIV Medicine, Case Western Reserve University, Cleveland, OH. Electronic address: robin.jump@va.gov.
authors.forename: Robin L P
authors.initials: RLP
authors.lastname: Jump
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D001364:Awareness; D003141:Communicable Diseases / Q000188:drug therapy* / Q000382:microbiology; D004352:Drug Resistance, Microbial; D004363:Drug Utilization / Q000592:standards*; D004496:Education, Continuing / Q000379:methods*; D004506:Education, Nursing / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009726:Nurses; D009735:Nursing Homes; D011361:Professional Competence
chemical_list: D000900:Anti-Bacterial Agents
keywords: Aged; Antimicrobial stewardship; Licensed practical nurses; Nursing home; Professional education; Registered nurses