Managing Urinary Tract Infections in Nursing Homes: A Qualitative Assessment

Schweizer, Anna K.; Hughes, Carmel; MacAuley, Domhnall; O’Neill, Ciarán

doi:10.1007/s11096-005-1191-5

Cited by 44 publications

(64 citation statements)

References 20 publications

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“…Previous qualitative studies of the perceptions of nursing home staff indicated that, especially around the issue of positive urine cultures, nurses were central to decisions about prescribing antibiotics [24,25]. Educational interventions that include both nurses and prescribers may be an effective means to influence the decisions leading to antibiotic prescriptions and to promote effective antimicrobial stewardship [26–30].…”

Section: Discussionmentioning

confidence: 99%

An online course improves nurses' awareness of their role as antimicrobial stewards in nursing homes

Wilson

Shick

Carter

et al. 2017

American Journal of Infection Control

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Background To support the role of nurses as active proponents of antimicrobial stewardship in long-term care facilities, we developed an educational intervention consisting of a free online course comprised of 6 interactive modules. Here, we report the effect of the course on the knowledge, beliefs and attitudes towards antimicrobial stewardship of nurses working in long-term care facilities. Measurements We used a paired pre- and post-course survey instrument to assess nurses’ knowledge regarding the care of long-term care facility residents with infections as well as attitudes and beliefs regarding antimicrobial stewardship. Results 103 respondents, RNs or LPNs, completed the pre and post-surveys. Their mean knowledge scores improved, from 75% (pre-course) to 86% (post-course, P < 0.001). Following the course, nurses’ agreement that their role influences whether or not residents receive antimicrobials increased significantly (P < 0.001). Discussion The online course improves nurses’ knowledge regarding the care of long-term care facility residents with infections and improves their confidence to engage in antimicrobial stewardship activities. Conclusion Empowering nurses to be antimicrobial stewards may help reduce unnecessary antibiotic use among institutionalized older adults.

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Section: Discussionmentioning

confidence: 99%

An online course improves nurses' awareness of their role as antimicrobial stewards in nursing homes

Wilson

Shick

Carter

et al. 2017

American Journal of Infection Control

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“…This is intriguing as prescribing in residential care is clearly a team effort with input from more than just the prescriber (Chen et al, 2010). Nurses take a central role in decisions about antibiotics (Schweizer et al, 2005) and GPs acknowledge that their prescribing in nursing homes is influenced by families and staff (Russell and Gallen, 2003), however in this analysis the GP perceptions were related to psychotropic use, not the nurses. This reinforces the need to put the prescriber at the centre of strategies to improve appropriate use of psychotropic medication and it is plausible that trying to impact on medication philosophy may be an avenue to explore.…”

mentioning

confidence: 87%

Is psychotropic medication use related to organisational and treatment culture in residential care

Peri

Kerse

Moyes

et al. 2015

Journal of Health Organization and Management

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“…Previous research has shown that in the long-term care environment, nursing staff can be the driving force behind antibiotic prescribing [6,7,10,25,28,29]. Physicians often rely on the nursing staff's assessment of the resident and may not visit a patient in an LTCF to confirm diagnosis.…”

Section: Medical and Nursing Staffmentioning

confidence: 99%

Strategies and challenges of antimicrobial stewardship in long-term care facilities

Dyar

Pagani

Pulcini

2015

Clinical Microbiology and Infection

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As people are living longer the demand for long-term care facilities (LTCFs) continues to rise. For many reasons, antimicrobials are used intensively in LTCFs, with up to a half of this use considered inappropriate or unnecessary. Over-use of antimicrobials can have direct adverse consequences for LTCF residents and promotes the development and spread of resistant bacteria. It is therefore critical that LTCFs are able to engage in antimicrobial stewardship programmes, which have the potential to minimize the antibiotic selective pressure, while improving the quality of care received by LTCF residents. To date, no antimicrobial stewardship guidelines specific to LTCF settings have been published. Here we outline the scale of antimicrobial use in LTCFs and the underlying drivers for antibiotic over-use. We further describe the particular challenges of antimicrobial stewardship in LTCFs, and review the interventional studies that have aimed to improve antibiotic use in these settings. Practical recommendations are then drawn from this research to help guide the development and implementation of antimicrobial stewardship programmes.

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Managing Urinary Tract Infections in Nursing Homes: A Qualitative Assessment

Abstract: The management approach to UTIs varied greatly and was a more complex process than anticipated. Identification of the component steps will be used to perform an economic evaluation of UTIs in nursing homes.

Cited by 44 publications

References 20 publications

An online course improves nurses' awareness of their role as antimicrobial stewards in nursing homes

An online course improves nurses' awareness of their role as antimicrobial stewards in nursing homes

Is psychotropic medication use related to organisational and treatment culture in residential care

Strategies and challenges of antimicrobial stewardship in long-term care facilities

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