ArticleBMC geriatrics2022
Implementing an intervention to reduce use of antibiotics for suspected urinary tract infection in nursing homes - a qualitative study of barriers and enablers based on Normalization Process Theory.
Article in BMC geriatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Supporting translation of research evidence into practice-the use of Normalisation Process Theory to assess and inform implementation within randomised controlled trials: a systematic review.Implementation science : IS · 2023Pooled it
- Effects of deprescribing antidepressants in nursing home residents with dementia-a cluster randomized controlled trial.BMC primary care · 2025Trial
- Practice-level mechanisms contributing to successful implementation of a UTI antibiotic stewardship intervention: a qualitative study in Dutch general practices.BMC primary care · 2026Article
- Factors influencing urinary tract infection prevention and antibiotic stewardship in European nursing homes: an interview study with staff.European geriatric medicine · 2025Article
- Appropriateness of antibiotic use in nursing homes for suspected urinary tract infections: comparison across five European countries.European geriatric medicine · 2025Article
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- A shared approach to managing urinary tract infections in nursing homes improved perceived care quality, workload, and collaboration - a qualitative study.Scandinavian journal of primary health care · 2025Article
- Preventing urinary tract infection in older people living in care homes: the 'StOP UTI' realist synthesis.BMJ quality & safety · 2025Review
- Using behavioural science to improve antibiotic stewardship in Canadian long-term care homes: Protocol for a multi-center cluster randomized quality improvement study.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2025Article
- Rethinking Barriers and Enablers in Qualitative Health Research: Limitations, Alternatives, and Enhancements.Qualitative health research · 2024Article
- Strategies for older people living in care homes to prevent urinary tract infection: the StOP UTI realist synthesis.Health technology assessment (Winchester, England) · 2024Review
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- Identifying barriers and enablers to participation in infection surveillance in Australian residential aged care facilities.BMC public health · 2023Article
- Feasibility of a placebo-controlled trial of antibiotics for possible urinary tract infection in care homes: a qualitative interview study.BJGP open · 2023Article
Corrections and comments
- Commented on byGeriatrics.2022
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOveruse of antibiotics in the elderly population is contributing to the global health problem of antibiotic resistance. Hence, it is important to improve prescribing practices in care facilities for elderly residents. In nursing homes, urinary tract infection (UTI) is the most common reason for antibiotic prescription but inappropriate prescriptions are frequent. In order to reduce the use of antibiotics for suspected urinary tract infection in this context, a complex intervention based on education as well as tools for reflection and communication had been developed and trialed in a group of nursing homes. The presents study explored the barriers and enablers in implementing this complex intervention.
methodsAfter the intervention trial period, a qualitative interview study was performed in six of the nursing homes that had received the intervention. The study included 12 informants: One senior manager, four nurses, six healthcare assistants, and one healthcare helper. Normalization Process Theory was used to structure the interviews as well as the analysis.
resultsThe intervention was well received among the informants in terms of its purpose and content. The initial educational session had altered the informants' perceptions of UTI and of the need for adopting a different approach to suspected UTIs. Also, the study participants generally experienced that the intervention had positively impacted their practice. The most important barrier was that some of the interventions' clinical content was difficult to understand for the staff. This contributed to some problems with engaging all relevant staff in the intervention and with using the observation tool correctly in practice. Here, nurses played a key role in the implementation process by regularly explaining and discussing the intervention with other staff.
conclusionThe results suggest that it is possible to implement more evidence-based practices concerning antibiotics use in nursing homes by employing a combination of educational activities and supportive tools directed at nursing home staff.
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