Nurses have long driven research that reshaped infection prevention and control, even if their contributions often went unacknowledged.

Florence Nightingale was a 19th-century pioneer of data-driven healthcare. By collecting and analysing statistics during the Crimean War, she proved how sanitation could save lives. Throughout the 20th century, nurses were also indispensable to clinical research. They recruited participants, administered treatments, and safeguarded patient safety. Despite their vital research role, nurses’ contributions were too often overlooked, with the spotlight falling instead on physicians, pharmacists, and policymakers. Yet, some nurses stepped forward as research innovators, and their work remains strikingly relevant today.

One remarkable but forgotten example is Edna C. Morse. In 1931, she published 'Tests of Nursing Methods and Materials: The Hand Scrub' in the British Journal of Nursing. At a time when antibiotics were not yet in use, Morse and her colleagues designed a study that would not look out of place in a modern clinical trial.

They deliberately contaminated their hands with Serratia marcescens, a bacterium often used in experiments, and tested different washing techniques: lengthy five-minute scrubs, shorter three-minute scrubs with varied rinse ratios, and continuous washing under running water. To measure effectiveness, they rinsed their hands in sterile water, centrifuged the samples, and cultured the bacteria on agar plates.

The results were sobering. In nearly every trial, bacteria persisted, sometimes in large numbers. Only when careful attention was paid to the nails did bacterial counts fall significantly. Morse concluded that ordinary soap alone was not enough – stronger antiseptics were needed, but without damaging the skin from repeated use.

Her findings carried three powerful lessons. First, prevention is key: effective hand hygiene stops infection before treatment is needed. Second, technique is just as important as the product itself – how healthcare professionals’ scrub and rinse can make all the difference, a principle that continues today. Third, and perhaps most importantly, bedside nurses can also be innovators and researchers in their own right.

Nearly a century later, Morse’s work still resonates. Infection control remains a cornerstone of antimicrobial stewardship, and nurses continue to be at the forefront – testing, refining, and championing practices that keep patients safe.

The roots of antimicrobial stewardship are not just medical; they are deeply nursing-driven, grounded in the determination to prevent infection before it ever begins.