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Author ORCID Identifier

https://orcid.org/0000-0002-8791-3691

Date Available

7-29-2026

Year of Publication

2026

Document Type

DNP Project

Degree Name

Doctor of Nursing Practice

College

Nursing

Department/School/Program

Nursing

Faculty

Dr. Candice Falls

Committee Member

Dr. Jill Clemmons

Faculty

Dr. Melissa Czarapata

Abstract

Abstract

Background

Cardiac implantable electronic device infections remain a serious complication of permanent pacemaker implantation despite evidence-based infection prevention guidelines.

Local Problem

An academic electrophysiology laboratory identified inconsistent guideline-concordant antibiotic selection despite consistently high compliance with recommended antibiotic timing.

Methods

A nurse-led, quasi-experimental pre-post quality improvement project evaluated implementation of a standardized preoperative antibiotic prophylaxis protocol. Data from 36 permanent pacemaker implantations (16 pre-intervention, 20 postintervention) were analyzed.

Interventions

The intervention included a standardized antibiotic protocol, multidisciplinary staff education, and performance feedback.

Results

Guideline-concordant antibiotic selection improved from 37.5% to 95.0% (χ² = 11.27, P = .001). Antibiotic timing remained above 95%, and the mean post-education knowledge assessment score was 98%.

Conclusions

Standardizing antibiotic prophylaxis improved adherence to evidence-based practice and supported antimicrobial stewardship in the electrophysiology laboratory.

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