Date of Conferral

8-12-2026

Date of Award

August 2026

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Betsy Rogers

Abstract

Inconsistent antibiotic prescribing practices in an oral surgery clinic contributed to variation in antibiotic selection, timing, dosing, redosing when indicated, and duration. This variation limited adherence to evidence-based prescribing recommendations and highlighted the need for a workflow-based strategy to support antibiotic stewardship. The purpose of this quality improvement project was to increase use of a standardized antibiotic order set through reminder-based reinforcement and to improve evidence-based prescribing practices. The practice-focused question examined whether implementing the standardized antibiotic order set, supported by workflow-integrated reminders and ongoing performance feedback, would improve order-set utilization during a 6-week implementation period. The project was guided by the Plan-Do-Study-Act framework. During implementation, providers received education on the purpose and location of the order set, quick-reference materials were placed at workstations, electronic health record prompts were incorporated into the prescribing workflow, and weekly performance feedback was shared with the oral surgery chief. Baseline and post-implementation chart audits were completed using a standardized checklist to assess order-set utilization and provider acceptance. Data were analyzed using descriptive statistics, including frequencies and percentages. Forty-five eligible patient charts were reviewed during the 3-week baseline period, and 60 charts were reviewed during the 3-week post-implementation period. Standardized antibiotic order-set utilization increased from 29% at baseline to 85% following implementation, representing a 56-percentage-point increase. Provider acceptance increased from 57% to 90%. These findings suggest that integrating evidence-based prescribing tools into daily workflows, along with reminders and ongoing feedback, can improve adoption of standardized antibiotic prescribing practices. Continued provider education, periodic audit and feedback, and routine monitoring of order-set utilization may support the long-term sustainability of this low-burden antibiotic stewardship intervention.

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