Date of Award

Spring 2020

Document Type

DNP Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

Committee Chairperson

Jacquelyn Owens, DNP, CRNP

Committee Member

Kala Shahi, PhD, CRNP

Committee Member

Cheryl D. Schlamb, DNP, CRNP

Abstract

Antimicrobial resistance is a significant risk that threatens life, increases health complications, decreases antibiotic effectiveness, and increases healthcare cost. Overprescribing of antibiotics in outpatient settings is a key factor that has led to increased antibiotic resistance. There are more than 150 million antibiotics prescribed in outpatients annually; 30 percent of these antibiotic prescriptions are either unnecessary or inappropriately prescribed, with acute respiratory infections holding the position of the highest unnecessary use of antibiotics at 50 percent. Antibiotic stewardship is the effort to improve and measure antibiotic prescribing so that antibiotics are only prescribed when it is appropriate and necessary. This DNP project is based on the first core element of “commitment to optimizing antibiotic prescribing and patient safety”, which is one of the four core elements of outpatient antibiotic stewardship published by CDC in 2016. The Antimicrobial Stewardship Program (ASP) was implemented in a suburb clinic, which provides combined urgent and primary care. The focus of this ASP project was on acute respiratory infections. The quality project used a pre and post implementation design to collect data retrospectively three months pre and post project through review of electronic health records. The post intervention results showed unnecessary antibiotic prescriptions decreased by 17.27% (p-value is

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