Document Type



Doctor of Nursing Practice



Date of Defense


Graduate Advisor

Dr. Nancy Magnuson, DSN, APRN, PCNS, FNP-BC


Dr. Laura Kuensting, DNP, APRN, PCNS-BC, CPNP, CPEN

Dr. Deanna Powelson, DNP, APRN, FNP-BC



Problem: Antibiotic stewardship is an effort to evaluate and improve the use of antibiotics by providers and patients. Antibiotic stewardship programs (ASPs) promote the appropriate use of antibiotics. There is increasing evidence that supports the use of antibiotic stewardship programs in reducing antibiotic prescribing rates while continuing to maintain safe patient care. Research supports approaches with multiple interventions and ongoing commitment to antibiotic stewardship. However, information regarding long-term sustainability of antibiotic stewardship programs is lacking. The purpose of this quality assurance project was to assess long-term sustainability of a previously implemented ASP promoting appropriate prescribing of antibiotics for the treatment of viral upper respiratory tract infections (URIs) in an urgent care setting and identify measures to sustain long term interventions.

Methods: A retrospective medical record review from April 1-30, 2019, and April 1-30, 2020 was completed. Data were compared to data from the earlier project.

Results: A total of 240 charts were used in the retrospective chart review from April 2019 and 2020 for this study. The overall inappropriate antibiotic prescribing rate for 2019 was 6.7%, and for 2020 was 8.3%. These numbers were compared to the previously implemented program’s results. The comparison resulted in a sustained improvement in the inappropriate prescribing of antibiotics for URIs.

Implications for practice: Implications for future practice include integrating antibiotic stewardship training and education into new provider onboarding, adding treatment algorithms for diagnoses not maintaining improvement, monthly education, and continuous monitoring and feedback to all providers.

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