Date of Award

2018

Document Type

Capstone

Degree Name

Doctor of Nursing Practice (DNP)

Committee Chair

Gayle Casterline

Abstract

Dynamic issues associated with infection create unprecedented demands for quality healthcare improvements and modifications. Researchers found extended antibiotic infusions to be an effective treatment option with significant clinical benefits to patients and astounding cost savings. This scholarly project identified the emergence of several clinical issues threatening to undermine the intended patient responses to extended antibiotic infusion therapy in one large hospital system. Problem: Unrecognized infusion delays and short infusion durations created the need for an educational pilot initiative to improve the administration process of piperacillin/tazobactam on one nursing unit. Intervention: Nurses on the pilot unit received instruction regarding the pharmacodynamics of time-dependent antibiotics and the infusion management of dead space volumes. Random infusions were monitored post instruction for consistency and accuracy. Results: Of the 73 nurses who were emailed a self-instruction module, a total of 30 (41%) nurses submitted an attestation for completing the instruction. Each nurse completing the instruction responded 100% correctly to all five post-test questions (150 questions/150 correct). Of the randomly observed post-instruction infusions, 17 of 29 pumps (59%) were programmed to infuse according to the instruction. Infusions programmed for 100% of the duration ordered increased from zero to 59% post instruction. The difference in minimum inhibitory concentration (MIC) pre and post instruction demonstrated a 72% improvement in the therapeutic duration delivery of piperacillin/tazobactam. Conclusion: The educational intervention, designed to redefine the beginning of the extended antibiotic infusion, was recommended as a sustainable solution to this practice problem.

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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