Date of Conferral



Doctor of Nursing Practice (DNP)




Diane Whitehead


The overuse and inappropriate use of antibiotics for residents in long-term care facilities (LTCFs) is associated with significant unintended treatment harm with 50% to 70% of residents prescribed an antibiotic at least once in 12 months. The purpose of this project was to evaluate data from a quality improvement quality improvement initiative conducted at a 168-bed LTCF to implement a protocol of an antibiotic stewardship program (ASP) to reduce the overuse of antibiotics. The John Hopkins nursing evidence-based practice model guided this project to analyze health care provider compliance with implementation of protocol guidelines before and after the ASP program initiation. Evaluation of practitioner compliance over a 3-month period included measurement of the use of minimal diagnostic criteria for skin/soft tissue, urinary tract, and respiratory tract infections as part of the resident assessment prior to starting antibiotics; a 48-hour window used post initiation of antibiotics to evaluate the need for the continued and appropriate use of the drug; and the collection of specimens for diagnostic testing. Data analysis using descriptive statistics revealed a mean 43.7% improvement in compliance on the 3 measures of compliance with a range from 22.8% prior to the ASP to an increase to 72.4% after the ASP implementation. ASPs in LTCFs that improve compliance with evidence-based practice have the potential to promote positive social change in the health treatment of illness in and health promotion of individuals and the population overall by reducing the adverse outcomes from overuse of antibiotics.

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Nursing Commons