Knowledge and Self-Reported Practices on Antibiotic Administration and Antibiotic Stewardship among Nursing Staff in Surgical Wards at a Tertiary Care Unit, Central Sri Lanka

Background: Antimicrobial resistance (AMR) poses a significant global health threat, particularly in low- and middle-income countries. Nurses, integral to antibiotic administration, may inadvertently contribute to AMR due to knowledge and practice gaps. In surgical settings, improper antibiotic use can exacerbate resistance. Antimicrobial stewardship (AMS) programs aim to optimize antibiotic use and mitigate AMR.
Objectives: To assess surgical ward nurses' knowledge, attitudes, and self-reported practices regarding antibiotic administration, and to examine associations with professional experience, training, and demographics.
Methodology: A descriptive cross-sectional study was conducted among 130 nurses in the surgical units of the National Hospital, Kandy. A validated self-administered questionnaire evaluated knowledge, attitudes, and practices related to antibiotic administration. Data analysis included descriptive statistics, Chi-square and Fisher's exact tests for categorical variables, and Kruskal-Wallis and Mann-Whitney tests for continuous variables.
Results: Participants were predominantly female (80.8%), aged 30–40 years (53.8%), with diplomas (55.4%), and less than five years of experience (47.7%). Knowledge levels were moderate in 64.6% and poor in 18.5%. Notably, 16.9% believed antibiotics are effective against viral infections, and 32.3% did not recognize nausea/vomiting as signs of anaphylaxis. AMS awareness was moderate (60.8%). Practice gaps included correct IV drop rate calculation (61.5%) and cannula patency checks (60.0%). The mean practice score was 50.71 (SD 5.42), with 71.5% demonstrating good practices. Higher education correlated with better knowledge (p=0.003); attitudes and practices showed no significant demographic associations.
Conclusions: Identified gaps in knowledge, AMS awareness, and antibiotic administration practices among nurses highlight the need for targeted education and training to enhance practices and combat AMR.