Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2018

Description of the rationale and core domains of an antimicrobial stewardship in cancer specialist nursing role. (#212)

Belinda Lambros 1 2 , Karin Thursky 1 2 , Monica Slavin 1 2 , Jason Trubiano 1 2 3 , Benjamin Teh 1 2 , Gabrielle Haeusler 1 2 , Leon Worth 1 2 , Mei Krishnasamy 2 4
  1. Peter MacCallum Cancer Institute, Parkville, VIC, Australia
  2. National Centre for Infections in Cancer, Parkville, VIC, Austalia
  3. Infectious Diseases, Austin Health, Heidelberg, VIC, Australia
  4. Department of Nursing, University of Melbourne, Parkville, VIC, Australia


Approximately 45% of cancer patients are affected by sepsis and infection due to high risk therapies and prolonged or repeated healthcare utilisation[1]. Antimicrobial therapy the key element in the management of sepsis and the appropriate antibiotic choice requires careful consideration. Factors that influence antibiotic appropriateness include allergy status, drug, site of infection, underling co-morbidities, microbiology and drug-drug interactions. International evidence demonstrates that nurses are well placed to provide stewardship support to optimise patient care and aid antibiotic appropriateness.


This paper will describe the rationale for an antimicrobial stewardship specialist nursing role in a tertiary cancer centre, report on key role domains and outline the formative evaluation framework for successful implementation.


We developed an antimicrobial stewardship nurse-led role to address the following key domains:

  1. Antimicrobial Stewardship (AMS) – providing support to the multidisciplinary team (MDT) on appropriate antimicrobial prescribing, duration and route, assist with early discharge and referral to the Infectious Diseases team for complex patients.
  2. Sepsis – early intervention for sepsis pathway patients to ensure standardised care bundles are implemented.
  3. Low risk febrile neutropenia (LRFN) –risk stratification of, and where appropriate initiation of FN patient management in an ambulatory setting[2].
  4. Antibiotic Allergies – appropriate assessment of antibiotic allergy labels to minimise inappropriate prescribing and healthcare utilization[3].

Results and Conclusions

A formative evaluation design has been adopted to iteratively assess feasibility, acceptability, efficacy and sustainability of the AMS nurse specialist role. We will report on the impacts of the AMS nurse specialist role on the key domains of AMS practice.