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Reducing Inappropriate Antibiotic Prescribing for Adults With Acute Bronchitis in an Urgent Care Setting: A Quality Improvement Initiative.

Publication ,  Journal Article
Link, TL; Townsend, ML; Leung, E; Kommu, S; Vega, RY; Hendrix, CC
Published in: Adv Emerg Nurs J
2016

Acute bronchitis is a predominantly viral illness and, according to clinical practice guidelines, should not be treated with antibiotics. Despite clear guidelines, acute bronchitis continues to be the most common acute respiratory illness for which antibiotics are incorrectly prescribed. Although the national benchmark for antibiotic prescribing for adults with acute bronchitis is 0%, a preliminary record review before implementing the intervention at the project setting showed that 96% (N = 30) of adults with acute bronchitis in this setting were prescribed an antibiotic. This quality improvement project utilized a single-group, pre-post design. The setting for this project was a large urgent care network with numerous locations in central North Carolina. The purpose was to determine whether nurse practitioners and physician assistants, after participating in a multifaceted provider education session, would reduce inappropriate antibiotic prescribing for healthy adults with acute uncomplicated bronchitis. Twenty providers attended 1 of 4 training sessions offered in October and November 2015. The face-to-face interactive training sessions focused on factors associated with inappropriate antibiotic prescribing, current clinical practice guidelines, and patient communication skills. Retrospective medical record review of 217 pretraining and 335 posttraining encounters for acute bronchitis by 19 eligible participating providers demonstrated a 61.9% reduction in immediate antibiotic prescribing from 91.7% to 29.8%. Delayed prescribing, which accounted for a small percentage of the total prescriptions given, had a small but significant increase of 9.3% after training. Overall, this multifaceted, interactive provider training resulted in significant reductions in inappropriate prescriptions.

Duke Scholars

Published In

Adv Emerg Nurs J

DOI

EISSN

1931-4493

Publication Date

2016

Volume

38

Issue

4

Start / End Page

327 / 335

Location

United States

Related Subject Headings

  • Quality Improvement
  • Physician Assistants
  • Nurse Practitioners
  • North Carolina
  • Male
  • Inservice Training
  • Inappropriate Prescribing
  • Humans
  • Female
  • Bronchitis
 

Citation

APA
Chicago
ICMJE
MLA
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Link, T. L., Townsend, M. L., Leung, E., Kommu, S., Vega, R. Y., & Hendrix, C. C. (2016). Reducing Inappropriate Antibiotic Prescribing for Adults With Acute Bronchitis in an Urgent Care Setting: A Quality Improvement Initiative. Adv Emerg Nurs J, 38(4), 327–335. https://doi.org/10.1097/TME.0000000000000122
Link, Tamara L., Mary L. Townsend, Eugene Leung, Sekhar Kommu, Rhonda Y. Vega, and Cristina C. Hendrix. “Reducing Inappropriate Antibiotic Prescribing for Adults With Acute Bronchitis in an Urgent Care Setting: A Quality Improvement Initiative.Adv Emerg Nurs J 38, no. 4 (2016): 327–35. https://doi.org/10.1097/TME.0000000000000122.
Link TL, Townsend ML, Leung E, Kommu S, Vega RY, Hendrix CC. Reducing Inappropriate Antibiotic Prescribing for Adults With Acute Bronchitis in an Urgent Care Setting: A Quality Improvement Initiative. Adv Emerg Nurs J. 2016;38(4):327–35.
Link, Tamara L., et al. “Reducing Inappropriate Antibiotic Prescribing for Adults With Acute Bronchitis in an Urgent Care Setting: A Quality Improvement Initiative.Adv Emerg Nurs J, vol. 38, no. 4, 2016, pp. 327–35. Pubmed, doi:10.1097/TME.0000000000000122.
Link TL, Townsend ML, Leung E, Kommu S, Vega RY, Hendrix CC. Reducing Inappropriate Antibiotic Prescribing for Adults With Acute Bronchitis in an Urgent Care Setting: A Quality Improvement Initiative. Adv Emerg Nurs J. 2016;38(4):327–335.

Published In

Adv Emerg Nurs J

DOI

EISSN

1931-4493

Publication Date

2016

Volume

38

Issue

4

Start / End Page

327 / 335

Location

United States

Related Subject Headings

  • Quality Improvement
  • Physician Assistants
  • Nurse Practitioners
  • North Carolina
  • Male
  • Inservice Training
  • Inappropriate Prescribing
  • Humans
  • Female
  • Bronchitis