Date of Conferral



Doctor of Healthcare Administration, DHA


Health Services


Cheryl Cullen


Antibiotics were often over-prescribed in long term care facilities (LTCFs) and antibiotic stewardship guidelines, established by the CDC were not followed. The nursing home administrator was responsible for the quality of care for the residents and ensured that the facility met and/or exceeded the CMS antibiotic stewardship standard of care. The purpose of this quantitative study was to analyze operational secondary data collected from a Texas LTCF regarding antibiotic utilization for male and female residents over 65 years. The theoretical framework of the social cognitive theory was applicable for quality improvement in the LTCF setting. The data analysis showed that the male variable was the only statistically significant variable in the documentation of antibiotic treatment. Males had 1.79 times higher odds than female participants of having documentation of antibiotic treatment. A chi-square analysis was used to determine that there was no association between urine culture results and the antibiotic spectrum for treatment on record. There was a, moderate small negative correlation between the number of days reevaluated after initial antibiotic therapy with the length of antibiotic therapy explaining approximately 5% of the variation between the two variables. As the duration of antibiotic treatment increased, the number of days when the participants were reevaluated decreased. Positive social change occurred within the LTCF under study and was generalized to the long-term care population by informing health care leaders, nursing home administrators, clinicians, and public health leaders regarding actual versus required antibiotic documentation and quality of care.