Date of Award

Summer 2023

Degree Name

Doctor of Nursing Practice (DNP) in Family Nurse Practitioner

Department

Nursing

Faculty Chair

Dr. Megan Moore

Preceptor

Dr. Joseph Scott Hooks

Abstract

Background: The identified problem discussed for the DNP project is antimicrobial resistance in acute care settings associated with the overuse of broad-spectrum antibiotics. Antibiotics are often started before obtaining cultures, thus skewing the results. The overuse of antibiotics can lead to almost complete resistance. In a study reviewed by Olesen, et al., performed in 2011, 34% of people received an antibiotic, and 10% of people received 57% of all antibiotic prescriptions (Olesen, et al., 2018). According to the World Health Organization (WHO), for example, a 92% resistance rate prescribing Ciprofloxacin for urinary tract infections with an E.Coli bacteria. (World Health Organization, 2021).

Purpose: The DNP project focused on monitoring the timing of obtaining various cultures versus the timing of antibiotic administration to implement de-escalation of broad-spectrum antibiotics. The staff's education to obtain cultures before the administration of antibiotics will be a pillar of this project.

Methods: The primary intervention of this project was to initiate a staff huddle for participants, review guidelines and project goals, and issue flowsheet/checklist badge buddies for staff to wear. The nursing staff used this badge buddy when they are at the bedside collecting cultures or administering antibiotics to guide the clinical priority and perform tasks in the correct order.

Results: The results yielded a drastic decrease. Originally the rate of administering antibiotics prior to culture collection occurred at a rate of 78%. After the intervention of this DNP project was implemented, the rate of occurrence was 10%.

Conclusion: Implemented staff huddles and providing a flowsheet/checklist badge buddy offered an additional step of confirmation they are following correct guidelines which decreased rate of administering antibiotics prior to culture collection by 68%.

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