Date of Award

12-2024

Degree Type

Dissertation/Thesis

Degree Name

Doctor of Nursing Practice (DNP)

School

Leadership and Advanced Nursing Practice

Committee Chair

Dr. Lakenya Forthner

Committee Chair School

Leadership and Advanced Nursing Practice

Committee Member 2

Dr. Lisa Morgan

Committee Member 2 School

Leadership and Advanced Nursing Practice

Abstract

A pressing global health issue that significantly contributes to antibiotic resistance is the inappropriate antibiotic prescribing for Upper Respiratory Infections (URI’s) in urgent care settings (World Health Organization [WHO], 2022). The purpose of this doctoral project was to reduce inappropriate antibiotic prescriptions for URI at an urgent care in D’Iberville, Mississippi through the implementation of an educational pamphlet.

A pre-post intervention project was conducted, collecting data on antibiotic prescribing practices via retrospective chart reviews before and after the educational intervention. Data was collected using a researcher developed screening tool based on Evidence based guidelines to distinguish viral vs bacterial infections. Pre-intervention data (July 29, 2024-September 11, 2024) consisted of 44 URI cases, while post-intervention data (August 2024—September 8, 2024) included 29 cases. Fisher’s Exact Test was used to compare prescribing rates and appropriateness.

Results revealed that the overall antibiotic prescribing rate rose from 20.5% to 62.1%, but the rate of inappropriate prescriptions remained stable, changing only slightly from 13.6% to 13.8%. Inappropriate prescriptions decreased from six to four even though the percentage slightly increased due to reduced sample size. A significant shift towards prescribing more narrow spectrum antibiotics was noted. Providers Pre intervention tended to prescribe broader spectrum antibiotics like azithromycin during the preintervention period. A change in the type of diagnostic cases seen also changed, with COVID-19 cases decreasing from 45% to 13% and sinusitis cases increasing to 22%. The educational intervention did slightly decrease inappropriate prescribing practices in the post intervention period. This demonstrated the potential of educational interventions to positively impact antibiotic stewardship. This doctoral project provided valuable information that could help guide future antibiotic stewardship efforts in urgent care settings.

ORCID ID

0009-0009-5266-3168

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