Nurse practitioners as antibiotic stewards: Examining prescribing patterns and perceptions.

• Little is known about what influences NP antibiotic prescribing for upper respiratory illness. • We asked NPs and Veteran patients about barriers and facilitators to antibiotic prescribing. • NPs balance patient education and patient-centered care with work system challenges. Advanced practice pro...

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Publicado en:American Journal of Infection Control Vol. 49; no. 8; pp. 1052 - 1058
Autores principales: Knobloch, Mary Jo, Musuuza, Jackson, Baubie, Kelsey, Saban, Karen L., Suda, Katie J., Safdar, Nasia
Formato: research Journal Article
Publicado: Elsevier B.V. Aug2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2021
      vid: 49
      iid: 8
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      pub: Elsevier B.V.
      place: New York, New York
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        151467432
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        10.1016/j.ajic.2021.01.018
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        atl: Nurse practitioners as antibiotic stewards: Examining prescribing patterns and perceptions.
      aug:
        au:
          Knobloch, Mary Jo
          Musuuza, Jackson
          Baubie, Kelsey
          Saban, Karen L.
          Suda, Katie J.
          Safdar, Nasia
        affil: William S. Middleton Memorial Veterans Hospital, Madison, WI
      sug:
        subj:
          Respiratory Tract Infections Drug Therapy
          Antibiotics Therapeutic Use
          Prescribing Patterns Evaluation
          Nurse Practitioners
          Veterans
          Patient Attitudes
          Attitude of Health Personnel
          Human
          Multimethod Studies
          Interviews
          Focus Groups
          Patient Safety
          Thematic Analysis
          Health Services Accessibility
          Trust
          Confidence
          Nurse Prescribing
      ab: • Little is known about what influences NP antibiotic prescribing for upper respiratory illness. • We asked NPs and Veteran patients about barriers and facilitators to antibiotic prescribing. • NPs balance patient education and patient-centered care with work system challenges. Advanced practice providers in the outpatient setting play a key role in antibiotic stewardship, yet little is known about how to engage these providers in stewardship activities and what factors influence their antibiotic prescribing practices. We used mixed methods to obtain data on practices and perceptions related to antibiotic prescribing by nurse practitioners (NP) and Veteran patients. We interviewed NPs working in the outpatient setting at one Veterans Affairs facility and conducted focus groups with Veterans. Emerging themes were mapped to the Systems Engineering Initiative for Patient Safety framework. We examined NP antibiotic prescribing data from 2017 to 2019. We interviewed NPs and conducted Veteran focus groups. Nurse practitioners reported satisfaction with resources, including ready access to pharmacists and infectious disease specialists. Building patient trust was reported as essential to prescribing confidence level. Veterans indicated the need to better understand differences between viral and bacterial infections. NP prescribing patterns revealed a decline in antibiotics prescribed for upper respiratory illnesses over a 3-year period. Outpatient NPs focus on educating the patient while balancing organizational access challenges. Further research is needed to determine how to include both NPs and patients when implementing outpatient antibiotic stewardship strategies. Further research is also needed to understand factors associated with the decline in nurse practitioner antibiotic prescribing observed in this study.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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