Mathew Reynolds

Degree Name

Master of Science in Nursing (MSN)

Document Type

Major Paper


School of Nursing




Antibiotic resistance has been identified by both the Center for Disease Control and the World Health Organization as a worldwide epidemic. Antimicrobial stewardship programs have been utilized at inpatient settings that include educational programs about antibiotic resistance. A systematic review was conducted to evaluate the effectiveness of antimicrobial resistance education in outpatient settings. The databases searched were MEDLINE, PubMed, Google Scholar and CINAHL. PRISMA checklist and flow diagram were used for identifying the randomized control trials for the systematic review. A total of five articles were identified and organized using data collection tables. The Critical Appraisal Skills Programme (CASP) checklist was used to assess the quality of the trials. All five of the articles showed improvement in overall antibiotic prescribing with education in an outpatient setting. Limitations to the studies included patient/provider drop-out rates, changing diagnoses to order antibiotics, lack of inclusion of all antibiotics ordered by practices, time of year the studies took place, and provider access to training regardless of being in sample. Implications for advanced practice nursing were identified as education, starting antibiotic research, utilizing APRN in research and leadership were discussed. Further research is indicated in the effectiveness of outpatient teaching to reduce antibiotic resistance as well as other areas of research the antimicrobial stewardship programs are utilizing in the inpatient settings.

Included in

Nursing Commons