Anestasia Wharton, Bonnie Jerome-D'Emilia, Margaret Avallone
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Improving Antibiotic Overuse in Primary Care: A Multimodal Quality Improvement Project.
Purpose: Antibiotic overuse has increased over time related to provider knowledge gaps about best practices, provider perception of patient expectations on receiving an antibiotic, possible pressure to see patients in a timely fashion, and concerns about decreased patient satisfaction when an antibiotic is not prescribed. The Centers for Disease Control and Prevention estimates that up to 30% of antibiotics are inappropriately prescribed in the outpatient setting.
Approach: This quality improvement project consisted of a multimodal approach to decrease inappropriate antibiotic prescribing for viral upper respiratory infections (URIs) by using provider education, passive patient education, and clinical decision support tools based on Centers for Disease Control and Prevention recommendations and the Be Antibiotic Aware tool.
Outcomes: Following implementation, there was an 11% decrease in viral URI antibiotic prescribing, from a rate of 29.33% to 18.33% following the multimodal implementation.
Conclusion: The use of evidence-based education and treatment guidelines was found to decrease inappropriate antibiotic prescribing for patients diagnosed with viral URIs.
期刊介绍:
The purpose of Clinical Nurse Specialist™: The International Journal for Advanced Nursing Practice is to disseminate outcomes of clinical nurse specialist practice, to foster continued development o fthe clinical nurse specialist role, and to highlight clinical nurse specialist contributions to advancing nursing practice and health policy globally. Objectives of the journal are: 1. Disseminate knowledge about clinical nurse specialist competencies and the education and regulation of practice; 2. Communicate outcomes of clinical nurse specialist practice on quality, safety, and cost of nursing and health services across the continuum of care; 3. Promote evidence-based practice and innovation in the transformation of nursing and health policy for the betterment of the public welfare; 4. Foster intra-professional and interdisciplinary dialogue addressing nursing and health services for specialty populations in diverse care settings adn cultures.