Publication Date
2025
Presentation Length
Poster/Gallery presentation
College
Gordon E. Inman College of Nursing
Department
Nursing, School of
Student Level
Graduate
SPARK Category
Research
Faculty Advisor
Dr. Jennifer Sternberg
SPARK Session
10:45-11:15am Kathryn Dambrino - Poster: Doctor of Nursing Practice Scholarly Projects
Presentation Type
Poster
Summary
Project Title: Quality Improvement Initiative to Decrease Excessive Testing for Streptococcal Pharyngitis in Adults in an Outpatient Clinic Setting
Background and Rationale: Current guidelines recommend utilization of a clinical decision-making tool, like the Centor score, in conjunction with confirmatory diagnostic methods, such as a throat culture or rapid test, rather than either method alone. The existing practice at the clinic site was to test most adults with upper respiratory infection symptoms (e.g., sore throat, cough, fever, sinus congestion) with little discretion. With the reported prevalence of streptococcal pharyngitis or “strep throat” in adults being 5-15%, universally testing adult patients could result in a positive test due to being a carrier, despite the causative organism of pharyngitis likely being viral. This contributes to antibiotic misuse and potentially antimicrobial resistance.
SMART Aim: The aim of this project was to decrease unnecessary rapid testing for Group A pharyngitis by 40% in patients over the age of 18 who present with upper respiratory symptoms to a primary care clinic in Murfreesboro, Tennessee, by December 13, 2024.
Methods: The protocol for the QI initiative called for the provider to calculate a Centor score prior to performing a rapid test for strep throat and to document the score in the encounter note. Ideally, a rapid strep test should only be performed for a Centor score ≥ 2. Data collection and compliance rates were completed by a chart review during implementation.
Outcomes: This QI initiative resulted in a 56% reduction in unnecessary testing for streptococcal pharyngitis. Also, antibiotic prescriptions were reduced by 20%. There was no significant change in the length of visit in minutes or significant increase in point-of-care testing for other URIs, such as Covid-19 or Influenza A & B. There were no missed cases of strep throat during the implementation.
Recommended Citation
Roussey, Hana; Sternberg, Jennifer; and Phillippi, David, "Quality Improvement Initiative to Decrease Excessive Testing for Streptococcal Pharyngitis in Adults in an Outpatient Clinic Setting" (2025). SPARK Symposium Presentations. 459.
https://repository.belmont.edu/spark_presentations/459
