Date of Award
Evidence-Based Project Report
Doctor of Nursing Practice (DNP)
Antibiotic overuse is a major contributor to antibiotic resistance that is estimated to be responsible for 23,000 deaths annually in the United States (Durante et al., 2017; Garcia et al., 2016). Upper respiratory tract infections (URTIs) are speculated to be a leading contributor to the overprescribing of antibiotics (Aplin-Snider et al., 2020). The purpose of this project was to address the PICOT question: Does the implementation of patient education posters and protocol plus online training modules for providers (I) over an 8-week period or 30 patient charts (T) help to decrease antibiotic overprescription (O) in upper respiratory tract infections (P) in the urgent care setting compared to no intervention (C)? A multimodal approach targeting both providers and patients demonstrated the best results. Provider targeted interventions included a Centers for Disease Control and Prevention (CDC) protocol outlining treatment recommendations for URTIs and two free continuing medical education (CME) online courses. Patient targeted interventions included education posters that were hung in the waiting and exam rooms. A chart review was conducted over an eight-week period with ICD-10 codes: viral URI/ common cold, pharyngitis, acute rhinitis, acute sinusitis, acute rhinosinusitis, and acute uncomplicated bronchitis/cough. A retrospective chart review was conducted over the same eight-week period in 2021. A chi square analysis was utilized to determine statistical significance and similarities of the two groups. Statistically significant findings were found between the two groups in terms of their age, sex, race, and ICD 10 codes used (p>0.05). The primary outcome was not statistically significant (p>0.05); however, it was found to be clinically significant. The clinical preintervention rate of antibiotic prescription rate was 6/30 cases or 20%, whereas the postintervention rate of antibiotic prescription rate was 2/30 or 6%. These findings highlight the need for more research on implementing strategies to help further decrease antibiotic overprescription.
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Boudaia, Amina, "Antibiotic Over Prescription for Upper Respiratory Tract Infections" (2023). Evidence-Based Practice Project Reports. 195.