Date of Graduation

Spring 5-20-2021

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions




Family Nurse Practitioner

First Advisor

Wanda Borges

Second Advisor

Francine J Serafin-Dickson

Third Advisor

Nancy Selix


Antimicrobial resistant organisms are a growing threat in the United States and globally. It has become the expectation that healthcare institutions, including hospitals, contribute resources to create and maintain antimicrobial stewardship programs to decrease antimicrobial resistance, improve patient outcomes, and decrease the spread of multi-drug resistant organisms. The methods utilized to evaluate antimicrobial stewardship at hospitals often only evaluate outcome measures and fail to capture knowledge of the hospital antimicrobial stewardship program among prescribers, clinical pharmacists, and nurses, as well potential barriers to antimicrobial stewardship among healthcare providers. The purpose of this Doctor of Nursing project is to implement and evaluate the use of tracer methodology to evaluate both implementation and outcomes of a hospital antimicrobial stewardship program. For this project, a tracer was designed by a multidisciplinary team to evaluate treatment of community acquired pneumonia at a local 130-bed regional trauma center affiliated with a large regional not-for-profit health system. The hospital was motivated to conduct the evaluation in response to a suggestion from a state government agency active in promoting hospital ASPs. The results of this evaluation suggest that successful implementation of a tracer is reliant on the quality of questions, the abilities of the surveyor, response from participants, and recognition that antimicrobial stewardship is multifaceted. Further, the interpretation of tracer questions is not always straightforward and tracer results should be interpreted as such. When possible, tracer questions should be specific enough to produce results that are detailed and actionable.