Date of Conferral



Doctor of Nursing Practice (DNP)




Susan Hayden


The Centers for Medicare and Medicaid are requiring long-term care facilities (LTCFs) to implement antibiotic stewardship programs (ASPs) to alleviate overuse of antibiotics in the nursing home population. Current research shows that the benefits of ASPs include improved patient outcomes, reduced adverse events related to Clostridium difficile (C-diff) infection, improvement in rates of antibiotic susceptibilities, and optimized resource utilization. This project addressed the problem of antibiotic overuse and misuse in the geriatric population and whether the implementation of an ASP reduced the overuse of antibiotics, C-diff infection, and resistance rates in the LTCF. Application of the Johns Hopkins nursing model and Centers for Disease Control framework informed this project. An ASP was implemented by the organization. This project evaluated the program preASP and postASP over a 10-month period. A descriptive analysis was used to compare the number of new antibiotic starts, C-diff cases, and resistant cases before and after ASP implementation. The total number of cases of resistance declined from 12 to 10 cases after the ASP was implemented, which was a 16.67% decline. The number of monthly new antibiotic orders for the time period evaluated declined from 120 to 110 respectively, which was an 8.3% change. There was no change in the number of C-diff infections. The results demonstrated that implementing the ASP led to a decline in antibiotic misuse, overuse, and resistance cases. This project supports social change by expanding the healthcare team's knowledge regarding the project problem and informing future interventions to be implemented to help reduce antibiotic overuse and misuse in the geriatric population.