ArticleBMJ quality & safety2022
Virtual learning collaboratives to improve urine culturing and antibiotic prescribing in long-term care: controlled before-and-after study.
Article in BMJ quality & safety, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Implementation of antimicrobial stewardship interventions on prescribing rates for urinary tract infections in residential aged care facilities: a systematic review and meta-analysis.Systematic reviews · 2026Pooled it
- Effects of implementation strategies on nursing practice and patient outcomes: a comprehensive systematic review and meta-analysis.Implementation science : IS · 2024Pooled it
- Tailor swiftly: lessons learned from a nationwide implementation of an antimicrobial stewardship program for asymptomatic bacteriuria.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Current and emerging strategies to curb antibiotic-resistant urinary tract infections.Nature reviews. Urology · 2024Review
- Barriers to the implementation of antimicrobial stewardship programmes in long-term care facilities: a scoping review.The Journal of antimicrobial chemotherapy · 2024Article
- Virtual quality improvement collaborative with primary care practices during COVID-19: a case study within a clinically integrated network.BMJ open quality · 2024Article
- Diagnosis of urinary tract infections in the hospitalized older adult population in Alberta.PloS one · 2024Article
- International implementation of a care review process for mortality reviews: improving quality and safety virtually across the world.BMJ open quality · 2023Article
- Bacteriuria in older adults triggers confusion in healthcare providers: A mindful pause to treat the worry.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- A Time Series Analysis Evaluating Antibiotic Prescription Rates in Long-Term Care during the COVID-19 Pandemic in Alberta and Ontario, Canada.Antibiotics (Basel, Switzerland) · 2022Article
- Analysis of an Antibiotic Stewardship Program for Asymptomatic Bacteriuria in the Veterans Affairs Health Care System.JAMA network open · 2022Article
- Global resilience and new strategies needed for antimicrobial stewardship during the COVID-19 pandemic and beyond.Journal of the American College of Clinical Pharmacy : JACCP · 2022Article
- Decisions on antibiotic prescribing for suspected urinary tract infections in frail older adults: a qualitative study in four European countries.Age and ageing · 2022Article
- Contextual factors influencing complex intervention research processes in care homes: a systematic review and framework synthesis.Age and ageing · 2022Article
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13 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundUrine culturing practices are highly variable in long-term care and contribute to overprescribing of antibiotics for presumed urinary tract infections. The purpose of this study was to evaluate the use of virtual learning collaboratives to support long-term care homes in implementing a quality improvement programme focused on reducing unnecessary urine culturing and antibiotic overprescribing.
methodsOver a 4-month period (May 2018-August 2018), 45 long-term care homes were self-selected from five regions to participate in virtual learning collaborative sessions, which provided an orientation to a quality improvement programme and guidance for implementation. A process evaluation complemented the use of a controlled before-and-after study with a propensity score matched control group (n=127) and a difference-in-difference analysis. Primary outcomes included rates of urine cultures performed and urinary antibiotic prescriptions. Secondary outcomes included rates of emergency department visits, hospital admission and mortality. An 18-month baseline period was compared with a 16-month postimplementation period with the use of administrative data sources.
resultsRates of urine culturing and urinary antibiotic prescriptions per 1000 resident days decreased significantly more among long-term care homes that participated in learning collaboratives compared with matched controls (differential reductions of 19% and 13%, respectively, p<0.0001). There was no statistically significant changes to rates of emergency department visits, hospital admissions or mortality. These outcomes were observed with moderate adherence to the programme model.
conclusionsRates of urine culturing and urinary antibiotic prescriptions declined among long-term care homes that participated in a virtual learning collaborative to support implementation of a quality improvement programme. The results of this study have refined a model to scale this programme in long-term care.
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