Date of Conferral

2020

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Catherine Garner

Abstract

Overuse of antibiotics poses serious consequences for patient's well-being, including the risk for antibiotic resistance and adverse effects from inadequate and timely treatment. The emergence and frequency of multi-drug resistant bacteria are alarming global public health care experts, as these strains are resisting effective management of life-threatening infections. The gap in practice was that a retail pharmacy clinic did not have a practice guideline for the implementation of a wait-and-see prescription program as part of an antimicrobial stewardship program. The purpose of this project was to coordinate an interprofessional team to develop guidelines for this primary care setting. The practice-focused question addressed whether a multi-professional team could develop tailored guidelines that would result in the adoption as a standard of care in this retail clinic. This project emphasized the implementation of the theory of planned behavior in prescribing medications, improving attitudes toward a particular behavior, altering the norm, and controlling perceived behavior, resulting in a better health outcome. A 3-member team consisting of a nurse practitioner, primary care physician, and pharmacist evaluated the evidence-based practice guideline using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) tool rated on a 7-point Likert scale from strongly agree to strongly disagree. Findings showed 100% agreement as agree or strongly agree on 21 out of 23 items with partially agree on 2 items. No disagreement was noted. The guideline was submitted to project site leadership for adoption as a clinical standard. This guideline may be used in other retail clinics across the company and the United States to reduce the overuse of antibiotics and the risk of patients developing antibiotic resistance.

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