An Associate Professor at 777ӰԺ (DMU) Leicester has teamed up with NHS England to create a toolkit designed to help more nurses switch patients over to oral antibiotics from intravenous (IV) ones.
The switch from IV to oral antibiotics is a crucial step in patient care, but research from Dr Ryan Hamilton from the Leicester School of Pharmacy shows that one-third of nurses never suggest reviewing the intravenous to oral switch (IVOS), despite having the skills and authority to do so.
Of the 545 nurses who took part in the survey, 34.5 per cent said they relied on doctors to make an IVOS decision, and only half knew what their hospital’s IVOS policy was.
He believes that there needs to be more IVOS education for nurses, so he has teamed with NHS England to create a toolkit for NHS Trusts and university courses to use as part of their training.
Dr Hamilton said: “Nurses have so many other things to focus on that it’s traditionally seen as the medical role to review those drugs and make that decision, even though nurses spend more time with patients in hospitals and know them better than other health professionals.
“So what we're trying to do is empower and educate nurses about the safety and the benefits of taking patients off an IV drip when they’re ready to switch. If a nurse can make that switch for a patient receiving IV antibiotics three times a day, they can save themselves around 60 minutes to help other patients.
“We have produced a video, which we’re hoping will be used in every hospital and we’re developing a training pack to accompany that. It’s our hope that senior nurses will be able to deliver this training to their own teams, and it will become embedded into nurses's training.”
Watch: The five-minute educational video, funded by NHS England’s Antimicrobial Resistance (AMR) Programme, and produced by a multi-disciplinary team involving nurses and pharmacists.
Administering a single dose of IV antibiotics takes approximately 22 minutes, compared to just 80 seconds for an oral dose. Patients on oral antibiotics can be discharged from hospital sooner, so if more nurses are trained to spot and speak out when a patient is ready to make the switch, more hospital beds will be made available.
Oral antibiotics are also up to 20 times cheaper than IV ones and do not require additional equipment such as cannulas, syringes and wound dressings. They are also better for the environment, avoiding plastic waste and the incineration associated with IV treatments.
Dr Conor Jamieson MRPharmS, who worked with Professor Hamilton on the project, said: “As the largest clinical workforce in the NHS, nurses in secondary care are ideally placed to identify patients who are improving clinically and who may be suitable for switching to oral antibiotics.
“Our video aims to communicate useful information about how they can get involved in suggesting switches and the benefits this would bring to patient care, their own workload and the wider NHS”
The development of the toolkit and video rounds off an impressive year for Dr Hamilton, who was nominated for the 2025 Outstanding Pharmacy Early-career Researcher Award (OPERA), awarded by the Royal Pharmaceutical Society and the Pharmaceutical Journal.
The nomination follows his research into antibiotic-resistant infections, with his work on identifying the lived experiences and support needs of people living with resistant organisms one of his personal career highlights.
Within DMU, he has established a group within the Leicester School of Pharmacy to help academics develop their research skills, share best practice, and apply for research funding.
He has also worked with NHS England to run and evaluate an antibiotic amnesty campaign with community pharmacies in Leicestershire, which is now in its third year and encourages people to return any unused antibiotics to their pharmacy.
Speaking about his OPERA nomination, Dr Hamilton said: “I had two people nominate me for the [OPERA] award, so it's nice to get that level of recognition.”
Posted on Thursday 24 July 2025