Antimicrobial Resistance

Antimicrobial Resistance

Nurses play a critical role in antimicrobial stewardship (AMS). From diagnosing and prescribing to managing drug interactions and collaborating with other disciplines, nurses contribute significantly. In October 2019, the Public Health Agency of Canada (PHAC) gave CNA a grant to develop AMS competencies for all categories of nurses in all practice settings. The project was designed to reinforce safe and effective nursing practice for managing patients undergoing antimicrobial therapy. Its goal is to help reduce antimicrobial resistance (AMR) across Canada.

CNA is proud to introduce the Antimicrobial Stewardship Competencies: A Pan-Canadian Framework for Nurses. This framework serves as a pivotal guidance document for nurses nationwide in the battle against AMR.

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What is AMR?

AMR occurs when microorganisms (e.g., bacteria, fungi, viruses, parasites) evolve and become resistant to the medications normally used to treat their infections. This is a serious problem worldwide as infections that were once curable with standard treatment — such as specific strains of pneumonia, gonorrhea, tuberculosis — are now presenting as resistant to one or more antimicrobials (e.g., antibiotics, antifungal agents).

The quick spread of AMR has been attributed to a number of factors, most notably the misuse and overuse of antimicrobials. According to this WHO report, AMR has a significant impact on human health and the health-care system, as infections by drug-resistant antimicrobials are associated with poor health outcomes, including increased length of stay in hospital, complications, and mortality. Worldwide, it is estimated that AMR will become a leading cause of death by 2030. Nationally, a report from the Canadian Council of Academies estimates that by 2050, close to 400,000 lives in Canada will be lost due to AMR, costing the health-care system $120 billion.

Role of the nurse

Nurses have a critical role to play in the fight against AMR and can support the judicious use of antimicrobials in many ways, including:

  • Assess and monitor for signs and symptoms of infections and side-effects of antimicrobial treatment.
  • Prescribe and de-prescribe judiciously.
  • Act as stewards for microbiology and laboratory testing.
  • Educate patients and the public.
  • Implement infection prevention and control practices.
  • Ensure appropriate allergy recording.

AMR resources

cover of PDF for "Reflect before your collect"
Choosing Wisely Canada made several key recommendations around urinary tract infections.

Tools for practice