The role of nurse practitioners in outpatient healthcare has changed dramatically over the past decade.
As healthcare systems work to address physician shortages, improve access to care, and meet growing patient demand, nurse practitioners are increasingly serving as frontline healthcare providers across primary care, urgent care, retail health, student health, and rural healthcare settings. In many communities—particularly those with limited physician access—nurse practitioners are often the first and sometimes only provider available to evaluate patients, make treatment decisions, and guide appropriate care.
At the same time, antibiotic stewardship has become an increasing priority across healthcare. Providers are expected to make timely clinical decisions while balancing patient expectations, operational demands, and the need to reduce unnecessary antibiotic use.
These trends are converging in ways that are reshaping outpatient care.
Between 2011 and 2022, physician antibiotic prescribing rates declined by 32%, while prescribing rates among advanced practice providers increased by 157%.¹ This shift reflects a broader change in healthcare delivery: nurse practitioners are caring for more patients, managing increasingly complex clinical presentations, and practicing in some of the most operationally demanding healthcare environments in the country.
As the NP workforce continues to expand, so does its influence on prescribing patterns.
During acute respiratory infection visits, advanced practice providers prescribed antibiotics in 61% of encounters compared with 54% for physicians.² Another analysis found that advanced practice clinicians were associated with 30% higher odds of prescribing antibiotics during respiratory visits.³
Importantly, approximately 45% of respiratory visits involved diagnoses where antibiotics are rarely indicated.³
These statistics are not a reflection of provider capability. Rather, they highlight the reality that nurse practitioners are increasingly practicing on the front lines of respiratory care, where decisions must be made quickly and often with limited diagnostic information available during the patient encounter.
The same trend is being observed internationally. Between 2014 and 2021, antibiotic prescriptions written by nurse prescribers increased by 146%, prompting researchers to call for greater inclusion of nurses in antimicrobial stewardship initiatives.⁵
The message is clear: nurse practitioners are no longer a peripheral audience in antibiotic stewardship discussions. They are central to them.
Most nurse practitioners do not need additional education on antibiotic stewardship.
They understand the risks associated with unnecessary antibiotic use, including antimicrobial resistance, adverse drug events, avoidable healthcare costs, and the long-term impact on public health.
The challenge is putting stewardship principles into practice in real-world clinical environments.
Many nurse practitioners practice in urgent care centers, primary care offices, retail clinics, student health centers, and rural healthcare settings where patient volumes are high and treatment decisions must be made quickly. Unlike hospital environments, many outpatient settings do not have immediate access to laboratory diagnostics, infectious disease specialists, or antimicrobial stewardship teams.
At the same time, patients expect answers during the initial visit.
Providers are expected to evaluate the patient, determine an appropriate treatment plan, educate the patient, document the encounter, and maintain patient flow—all within a limited amount of time.
The challenge isn't understanding stewardship. The challenge is making confident respiratory care decisions when additional diagnostic information may not be immediately available.
This challenge becomes even more apparent in the settings where nurse practitioners are increasingly practicing. National analyses have identified urgent care and telehealth as two of the highest-volume settings for low-value antibiotic prescribing.⁴ These environments are often characterized by high patient throughput, limited diagnostic resources, and pressure to make treatment decisions quickly.
Geography further complicates the issue. Antibiotic prescribing rates remain highest in rural communities and throughout much of the Southeastern United States. In seven Southeastern states, nurse practitioner prescribing rates increased from 163 prescriptions per 1,000 population in 2011 to 393 prescriptions per 1,000 population in 2022.¹ These are often the same regions where nurse practitioners play a critical role in maintaining access to care.
Healthcare organizations are increasingly looking for solutions that support respiratory care decision-making without creating additional operational complexity.
One example is WellStreet Urgent Care, which recently expanded the implementation of FebriDx® to 44 locations following its initial evaluation of the test.
That expansion reflects a broader trend occurring across outpatient healthcare. Organizations are looking for practical tools that can support clinical decision-making while fitting naturally into existing workflows.
This is particularly important in high-volume outpatient settings where providers need actionable information during the patient encounter—not hours or days later.
Today, FebriDx is being utilized across more than 100 clinical locations in 18 states, including urgent care, primary care, concierge medicine, and collegiate health settings. As adoption continues to grow, healthcare organizations are increasingly recognizing the value of obtaining objective information during the initial visit.
Built for the Way Nurse Practitioners Practice
Nurse practitioners are often asked to make respiratory treatment decisions before laboratory results are available.
When symptoms overlap and patients are seeking immediate answers, having objective information available during the visit can be invaluable.
FebriDx is a rapid point-of-care test that uses a fingerstick blood sample to aid in the differentiation between bacterial infection and non-bacterial etiology during the initial visit.
Results are available after 10 minutes, allowing providers to incorporate objective information into clinical decision-making while the patient is still present.
Designed specifically for outpatient settings, FebriDx is:
In addition, FebriDx has demonstrated a 99% negative predictive value for ruling out bacterial infection, providing clinicians with additional information to support respiratory care decisions and antibiotic stewardship efforts.
For nurse practitioners, the value extends beyond the test result itself. Objective information can support patient conversations, reinforce treatment recommendations, and help providers make more informed decisions without disrupting clinic operations.
As nurse practitioners continue to play an increasingly important role in respiratory care delivery, access to actionable information during the initial visit may represent one of the greatest opportunities to improve both clinical confidence and workflow efficiency.