Date of Conferral

3-5-2025

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Barbara Niedz

Abstract

Urinalyses and urine cultures are being ordered at the facility of concern without regard to patient history/symptomatology, leading to inappropriate treatment of asymptomatic bacteriuria (ASB) and unnecessary antibiotic prescriptions. The following practice-focused question was developed to address this practice concern: Can an educational program focused on diagnostic stewardship and the mitigation of treatment of asymptomatic bacteriuria improve clinician awareness, knowledge, and confidence in identifying and diagnosing asymptomatic bacteriuria in patients over age 65 in the outpatient setting? Thus, the purpose of this doctor of nursing practice (DNP) project was to close the identified knowledge and attitude gap in a moderate-size primary care practice. An educational program with pre- and posttesting was provided to 24 primary care clinicians in a large suburban practice. Analysis of the results was completed using SPSS. The mean score of six knowledge questions improved from 4.58 to 5.83 posttraining (Z = 2.549, p = .011). The mean attitudes score on a Likert scale improved from 6.33 to 3.416 posttraining, demonstrating statistical significance (Z = -2.814, p = .005). This suggests that a clear, concise educational intervention will positively impact the clinical management of urinary tract infection (UTI)/ASB and significantly impact the critical decision of when to order urine diagnostics. From a diversity, equity, and inclusion perspective, this educational intervention addresses falsehoods and practices not backed by evidence, such as the routine annual ordering of urinalyses and the idea that confusion in elderly patients without urinary symptoms correlates with UTI. By addressing patients and their unique symptoms, clinicians break down the barriers to equity and inclusion, creating positive social change.

Download

Included in

Nursing Commons

Share

 
COinS