First Advisor

Lynn Wimett

Second Advisor

Patricia Cullen


Rueckert-Hartman College for Health Professions

Degree Name

Doctor of Nursing Practice

Document Type

Thesis - Open Access

Number of Pages

83 pages


Executive Summary

Strategies for Uncomplicated Upper Respiratory Infections and Patient Satisfaction.


Overuse or inappropriate use of antibiotics is a major contributing factor to reduced drug efficacy, and increased prevalence of resistant pathogens. The two delayed prescription strategies combined with the patient education showed a promising reduction in inappropriate antibiotics use. However, it is not yet clear which delay prescription strategy is the most effective between these two strategies.


The purpose of this QI project was to investigate if an educational program increased patients’ knowledge of proper antibiotic use, perceptions of severity of symptoms, their belief in symptomatic treatment for viral illnesses, their satisfaction in their treatment plan and the differences in number of antibiotic prescriptions filled for two different delayed antibiotics strategies designed to reduce inappropriate use of antibiotics for adult patients with uncomplicated URIs patients’ at an urgent care clinic in Charles County, Maryland


Promote appropriate antibiotic use in the adult patients with uncomplicated URIs through a coordinated program of education and delayed prescription strategies in an urgent care setting.


Encourage antibiotic stewardship through a coordinated program that promotes the appropriate use of antibiotic, improve patient outcomes, reduces microbial resistance and decrease the spread of infections caused by multidrug-resistant organisms.


The goals of the study were to measure the impact of an educational program on the variables above and compare the two different delayed prescribing strategies.


Self-report instruments were used to investigating the effectiveness in an education program to improve patients’ knowledge of appropriate antibiotics use and compare two different delayed prescribing strategies in reducing antibiotic prescriptions filled.

Outcomes and Results

The patient led delayed prescription strategy, in addition to the patient education, resulted in a statistically significant decreased of antibiotic prescriptions filled by subjects diagnosed with an uncomplicated URIs. The patients’ antibiotic use was strongly related to the severity of symptoms on day three. More than 50% of the patients stating that symptomatic treatment helped. The perceived helpfulness of symptomatic treatment is strongly associated with decreased antibiotics use in this study. The educational program did not make any statistically significance in decreasing the use of antibiotics, but it did help to increase the patient’s satisfaction.

Date of Award

Spring 2018

Location (Creation)

Colorado (state); Denver (county); Denver (inhabited place)

Rights Statement

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