Date of Award

Spring 5-15-2022

Document Type

DNP Project

Project Team Faculty Member

Dr. April Schmidt

Keywords

acute otitis media diagnosis, acute otitis media treatment, acute otitis media, urgent care, provider confidence, optical coherence tomography

Abstract

Acute otitis media (AOM) is one of the most common causes of pediatric infection worldwide at approximately 350 million visits per year, as well as one of the most challenging illnesses to diagnose for providers (Tong et al., 2018). This dilemma leads to antibiotics being inappropriately prescribed, at a rate of approximately 75% (Islam & Hassinger, 2018). This project sought to explore the impact of implementing an optical coherence tomography (OCT) device in an urgent care setting when assessing otalgia in patients 0 to 17 years of age. The three main objectives of the project were to increase provider confidence in both acute otitis media (AOM) and otitis media with effusion (OME) diagnoses, provide patient/parent satisfaction, and decrease unnecessary antibiotic prescribing to patients with complaints of otalgia. A cohort of 12 Urgent Care Advanced Practice Providers (APPs) were invited to participate in OCT device education and utilization, as well as complete an anonymous survey in the pre-implementation phase and subsequently every 30 days to assess the first two objectives based on a four-point Likert scale. At the end of the six-month project, provider confidence scores averaged 2.86 for AOM and 3.19 for OME, and patient/parent satisfaction averaged 3.28. Aggregate data on antibiotic prescribing rates was collected during both pre-implementation and evaluation phases to assess the final objective and found a 17.6% improvement in antibiotic prescribing rates. Device implementation in other specialties, trial of other OCT devices, and longer training periods are recommended for future studies.

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