Date Available

4-26-2017

Year of Publication

2017

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Sharon Lock

Clinical Mentor

Dr. Mollie Aleshire

Committee Member

Dr. Nancy Kloha

Abstract

Purpose

The purpose of this project is to evaluate adherence to Physician Quality Reporting System (PQRS) Measures #331 (delaying antibiotic treatment until at least seven days of symptoms) and #332 (prescribing amoxicillin or amoxicillin/clavulanate) on adult sinusitis treatment. Data was collected from patient encounters at the University of Kentucky College of Nursing Community Health Center (UKCONCHC) in Wilmore, Kentucky. To adhere to these quality measures would foster antibiotic stewardship. Further statistical analysis was completed to determine if gender or age bias was present in prescribing practices.

Methods

A retrospective chart audit was conducted to determine adherence to the quality measures. Records were also reviewed to determine if recommended antibiotics by the American Academy of Otolaryngology Head and Neck Surgery (AAOHNS) (Rosenfeld et al., 2015) were prescribed for patients with penicillin allergies. A total of 30 patient encounters met inclusion criteria. Information regarding patient age, gender, allergies, days of symptoms experienced, and antibiotic prescribed (if any) were collected.

Results

The adherence rate to Objective 1 (delaying antibiotic treatment until at least seven days of symptoms) was 60%. The adherence rate to Objective 2 (prescribing amoxicillin or amoxicillin/clavulanate) was 89.2%. The adherence rate to Objective 2, when adherence to Objective 1 was a prerequisite, was 53.5%. The adherence rate to Objective 3 (prescribing doxycycline or a fluroquinolone when a penicillin allergy is present) was 50%. No gender or age bias was observed in regard to antibiotic prescribing practices.

Conclusion

In conclusion, the adherence rates demonstrated adequate adherence to PQRS measures #331 and #332 and the AAOHNS guideline. Attention should be focused on improving adherence to PQRS measure #331 (delaying antibiotic therapy until at least seven days of symptoms).

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