Educating Nurse Practitioners to Avoid Urine Cultures to Prevent Overuse of Antibiotics

Unnecessary antibiotics are often ordered for positive urine cultures in long-term care (LTC) residents despite a lack of symptoms, indicating asymptomatic bacteriuria (ASB). Treating ASB with antibiotics can result in antibiotic-resistant organisms, allergic reactions to antibiotics, and secondary infections such as clostridium difficile. The purpose of this DNP project was to provide an evidence-based education intervention regarding management of ASB and UTIs with the hope of increasing the knowledge among nurse practitioners (NPs) that could be translated into practice and result in a decreased antibiotic use in LTC patients. The DNP project was grounded in Knowles’ adult learning theory and used a pretest, posttest, and survey to assess for increased knowledge. Forty-four individuals completed the pretest, 44 participated in the educational intervention; and 38 participants completed the posttest. Twenty participants completed the survey (n = 20), which suggested 95% of the participants were female and the majority of the participants (65%) were masters-prepared NPs. The average pretest score was 8.02 (SD =1.73) and the average posttest score was 9.63 (SD = 0.675). Since there was no unique identifier to match the pretest and posttest scores, a one-sample t-test was used to estimate the data. There was a statistically significant difference between the pretest and the posttest scores (t = 14.72, p \u3c 0.001), indicating an increase in knowledge among the participants. Translated into practice, the ordering of urine cultures and unnecessary use of antibiotics will decrease, resulting in positive patient and organizational outcomes and ultimately lead to positive social change