Nurses' Anxiety Mediates the Relationship between Clinical Tolerance to Uncertainty and Antibiotic Initiation Decisions in Residential Aged-Care Facilities

Med Decis Making. 2024 May;44(4):415-425. doi: 10.1177/0272989X241239871. Epub 2024 Mar 27.

Abstract

The impact of non-clinical factors (e.g., resident and family preferences) on prescribing is well-established. There is a gap in the literature regarding the mechanisms through which these preferences are experienced as pressure by prescribers within the unique context of residential aged-care facilities (RACFs).A significant relationship was found between nurses' anxiety, clinical tolerance of uncertainty, and the perceived need for antibiotics and assessment.As such, there is a need to expand stewardship beyond education alone to include interventions that help nurses manage uncertainty and anxiety and include other stakeholders (e.g., family members) when making clinical decisions in the RACF setting.

Keywords: antimicrobial resistance; anxiety; clinical decision making; prescribing; residential aged care; stewardship; tolerance of uncertainty; uncertainty.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents* / therapeutic use
  • Anxiety* / psychology
  • Decision Making
  • Female
  • Homes for the Aged*
  • Humans
  • Male
  • Middle Aged
  • Nurses / psychology
  • Nursing Homes
  • Uncertainty