Primary Care Provider Education for Fostering Antimicrobial Stewardship: A Quality Improvement Project

Abstract

Purpose. The purpose of this project was to implement an educational intervention for primary healthcare providers on antimicrobial stewardship interventions, including delayed prescribing and watchful waiting. Background. Antimicrobial stewardship is a practice involving the judicious use of antimicrobials to reduce antimicrobial resistance and promote population health. Most antimicrobial prescriptions originate from the primary healthcare setting, and up to half of these are inappropriately used for viral or otherwise self-limiting illnesses. Provider education is an essential strategy to bring to light specific antimicrobial stewardship interventions, such as delayed prescribing and watchful waiting, which can facilitate a reduction in inappropriate antimicrobial use. Methods. This quality improvement project used a descriptive design to determine the impacts of an educational intervention through assessing pretest and posttest questionnaires. The implementation was guided by Lewin’s change theory and followed the Institute of Healthcare Improvement’s Model for Improvement Plan-Do-Study-Act cycle. Five primary care providers from one practice site were invited via email to participate in a pretest questionnaire, short educational PowerPoint presentation, and posttest questionnaire, all provided on an electronic platform. Results. Three out of five providers at the implementation site participated in the entirety of the intervention. Participant providers demonstrated a strong baseline knowledge of antimicrobial stewardship. Participant providers increased their awareness of and attitudes toward antimicrobial stewardship interventions to be used in the primary healthcare setting after the educational intervention was implemented. Conclusions. This project indicates that an educational intervention for primary care providers can improve their knowledge, awareness, and attitudes toward utilizing specific interventions with their patients to promote antimicrobial stewardship. The impact of this intervention is difficult to determine due to the small scope of this project, so further PDSA cycles and investigation is recommended to determine the efficacy of targeted provider education. Future research might look at the impact of utilizing antimicrobial stewardship interventions among a sample of patients in the primary care setting.