Doctor of Nursing Practice Program

• Committee Chair Name & Credentials:
  Susanna Rudy, DNP, APRN, AG-ACNP, ENP
 

 

DNP Project Abstract

Antibiotic Stewardship in Primary Care

Purpose
The Centers for Disease Control and Prevention (CDC) estimates 30% of all antibiotics prescribed annually are unnecessary, which leads to antibiotic resistance and increased morbidity and mortality. The purpose of this quality improvement project was to decrease the rate of unnecessary antibiotic prescribing for adult patients with respiratory tract infections in primary care.

Methods
Antibiotic stewardship interventions of provider and patient education were implemented in October 2022 at a primary care clinic. Retrospective chart reviews determined baseline and intervention antibiotic prescribing rates for qualifying visits to determine if the rate improved with interventions. Pre- and post-intervention surveys were conducted to elicit provider views on antibiotic stewardship.

Results
The baseline chart review included 48 charts and the antibiotic prescribing rate was 41.67%. The intervention chart review included 19 charts and the antibiotic prescribing rate was 36.84%. The intervention demonstrated a 4.83% decrease in the rate of unnecessary antibiotic prescribing for adults with respiratory tract infections in primary care during the intervention period. Providers viewed patient education as an effective form of antibiotic stewardship.

Implications for Practice
Interventions were associated with modest improvement of antibiotic prescribing for adults with respiratory tract infections in primary care, which indicates the need for further and sustained antibiotic stewardship efforts. A literature review suggested peer comparison and personalized audit and feedback as effective strategies. Provider surveys indicated that use of printed patient education materials should be continued within the clinic.