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

Area of Science:

• Healthcare Management
• Infectious Diseases
• Patient Safety

Background:

• Advanced practice providers (APPs) in outpatient settings are vital for antibiotic stewardship.
• Limited understanding exists regarding APP engagement in stewardship and factors influencing prescribing.

Purpose of the Study:

• To explore antibiotic prescribing practices and perceptions among outpatient nurse practitioners (NPs) and Veteran patients.
• To identify factors influencing NP antibiotic prescribing and inform outpatient antibiotic stewardship strategies.

Main Methods:

• Mixed-methods approach combining interviews with NPs and focus groups with Veteran patients.
• Analysis of NP antibiotic prescribing data from 2017-2019.
• Thematic analysis mapped to the Systems Engineering Initiative for Patient Safety framework.

Main Results:

• NPs reported satisfaction with access to pharmacists and infectious disease specialists.
• Patient trust was essential for NP prescribing confidence; Veterans desired better understanding of infection types.
• A decline in antibiotic prescriptions for upper respiratory illnesses by NPs was observed over three years.

Conclusions:

• Outpatient NPs balance patient education with organizational access challenges.
• Further research is necessary to integrate NPs and patients into outpatient antibiotic stewardship.
• Investigating factors behind the observed decline in NP antibiotic prescribing is warranted.