Nursing Roles in Patient Education for Antimicrobial Stewardship: A Scoping Review.

AIM: To systematically map and conceptually organise evidence on nurse-led and nurse-involved patient education in antimicrobial stewardship (AMS) across three domains: nurses' educational roles and capacity, reduction of unnecessary antibiotic use and antibiotic adherence and treatment completion.

DESIGN

Scoping review.

METHODS

This review followed the PRISMA-ScR guidelines. Studies examining nurse-led or nurse-involved patient education related to AMS, including nurses' roles and capacity to provide such education, were eligible. Evidence was narratively synthesised using a domain-based analytical framework informed by the Capability, Opportunity, Motivation-Behaviour (COM-B) model.

DATA SOURCES: PubMed, CINAHL, Cochrane Library and Web of Science were searched from inception to March 2026, supplemented by a targeted search in August 2026.

RESULTS

Thirty-four studies were included. Most (n = 27) addressed nurses' educational roles and capacity, identifying nurses as key providers of patient education but revealing gaps in AMS knowledge and training. Two studies evaluated nurse-led interventions targeting unnecessary antibiotic use and reported reductions in antibiotic prescribing or consumption; neither directly assessed patient expectations or demand. Five studies examined adherence-related outcomes, suggesting that nurse-led education and follow-up may improve antibiotic adherence and treatment completion. Evidence was heterogeneous across study designs, settings and outcome measures, with limited integration across the three domains.

CONCLUSION

Nurses have an important role in AMS patient education, particularly in supporting patient knowledge and antibiotic adherence. However, their potential to influence patient expectations and demand for unnecessary antibiotics remains understudied. The three domains may represent interconnected components of a behavioural pathway linking nurses' educational capacity with patient antibiotic-use behaviours. Future research should develop and evaluate theoretically informed, integrated nurse-led interventions across the continuum of care.

REPORTING METHOD: PRISMA-ScR checklist.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.