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.
Development of antimicrobial stewardship competencies
In October 2019, the Public Health Agency of Canada (PHAC) gave CNA a grant to develop antimicrobial stewardship (AMS) competencies for nurse prescribers and nurses in long-term care. The project is designed to reinforce safe and effective nursing practice for managing patients undergoing antimicrobial therapy. Its goal is to help reduce AMR across Canada. For more information about this project, please contact firstname.lastname@example.org.
- Member of the Federal Action Plan on Antimicrobial Resistance and Use in Canada working group. CNA is involved in PHAC’s development of a pan-Canadian plan to combat AMR.
- Co-lead of the chief public health officer’s health professions forum’s AMR sub-group. CNA is co-lead of this sub-group, whose aim is to support health-care providers in addressing AMR.
- CNA advocated for the inclusion of AMR in the International Council of Nurses’ strategic priorities. For example, CNA president Claire Betker presented on nursing’s leadership role in AMS at the council’s congress in Singapore in 2019
- CNA has partnered with Choosing Wisely Canada and members of the Canadian Network of Nursing Specialties to identify recommendations to reduce overuse of antibiotics.
- CNA’s federal government submissions on AMR:
Tools for practice