Date of Award
12-2025
Degree Type
Dissertation/Thesis
Degree Name
Doctor of Nursing Practice (DNP)
School
Leadership and Advanced Nursing Practice
Committee Chair
Dr. Lisa Morgan
Committee Chair School
Leadership and Advanced Nursing Practice
Committee Member 2
Dr. Lakenya Forthner
Committee Member 2 School
Leadership and Advanced Nursing Practice
Abstract
Inappropriate corticosteroid prescribing for acute upper respiratory tract infections (AURTIs) remains a prevalent issue in outpatient primary care despite limited evidence supporting their use in otherwise healthy adults. This Doctor of Nursing Practice (DNP) project aimed to reduce inappropriate corticosteroid prescribing for AURTIs by implementing an evidence-based clinical practice guideline over an eight-week period in a rural primary care setting.
The doctoral project employed pre- and post-intervention design. Providers were introduced to the corticosteroid guideline derived from the 5-Minute Clinical Consult, emphasizing appropriate use criteria for corticosteroids in AURTI cases (Unbound Medicine Inc., 2025). Educational outreach and clinical reminders were used to support adherence. A Knowledge, Attitudes, and Practices (KAP) survey was administered to providers before and after the intervention to evaluate changes in prescribing behavior, clinical knowledge, and perceptions regarding corticosteroid use.
Chart reviews of patient encounters for AURTIs during the pre- and post-intervention phases were conducted to measure corticosteroid prescribing rates. The primary outcome was the rate of inappropriate corticosteroid prescriptions, defined by deviation from the guideline in patients without chronic pulmonary conditions, such as chronic obstructive pulmonary disease and asthma.
Results demonstrated a reduction in inappropriate corticosteroid prescribing following guideline implementation. Post-intervention KAP survey responses indicated improved provider knowledge and increased awareness of evidence-based prescribing practices. Attitudinal shifts and enhanced self-reported prescribing behaviors supported the success of the intervention. Providers expressed greater confidence in aligning their practices with evidence-based recommendations.
This doctoral project highlights the impact of targeted educational interventions and evidence-based tools in promoting guideline adherence and increasing high-value care. Findings support the sustainability of guideline-driven practice changes through provider engagement and ongoing clinical education. Future recommendations include expanding the intervention across other clinics and evaluating long-term prescribing patterns to reinforce sustained improvement.
Copyright
Cody Allen Boyd Hyatt, 2025
Recommended Citation
Hyatt, Cody Allen Boyd, "Evaluating the Impact of Evidence-Based Guidelines on Corticosteroid Prescribing for Acute Upper Respiratory Infections in Outpatient Primary Care" (2025). Doctoral Projects. 283.
https://aquila.usm.edu/dnp_capstone/283