Preventing urinary tract infection in older people living in care homes: the ‘StOP UTI’ realist synthesis

Prieto, Jacqui, Wilson, Jennie, Tingle, Alison, Cooper, Emily, Handley, Melanie, Rycroft Malone, Jo, Bostock, Jennifer and Loveday, Heather (2024) Preventing urinary tract infection in older people living in care homes: the ‘StOP UTI’ realist synthesis. BMJ Quality and Safety: 016967. pp. 1-12. ISSN 2044-5415
Copy

Background Urinary tract infection (UTI) is the most diagnosed infection in older people living in care homes.Objective To identify interventions for recognising and preventing UTI in older people living in care homes in the UK and explain the mechanisms by which they work, for whom and under what circumstances.Methods A realist synthesis of evidence was undertaken to develop programme theory underlying strategies to recognise and prevent UTI. A generic topic-based search of bibliographic databases was completed with further purposive searches to test and refine the programme theory in consultation with stakeholders.Results 56 articles were included in the review. Nine contexttextendashmechanismtextendashoutcome configurations were developed and arranged across three theory areas: (1) Strategies to support accurate recognition of UTI, (2) care strategies for residents to prevent UTI and (3) making best practice happen. Our programme theory explains how care staff can be enabled to recognise and prevent UTI when this is incorporated into care routines and activities that meet the fundamental care needs and preferences of residents. This is facilitated through active and visible leadership by care home managers and education that is contextualised to the work and role of care staff.Conclusions Care home staff have a vital role in preventing and recognising UTI in care home residents.Incorporating this into the fundamental care they provide can help them to adopt a proactive approach to preventing infection and avoiding unnecessary antibiotic use. This requires a context of care with a culture of personalisation and safety, promoted by commissioners, regulators and providers, where leadership and resources are committed to support preventative action by knowledgeable care staff.All data relevant to the study are included in the article or uploaded as supplementary information.


picture_as_pdf
bmjqs-2023-016967.full.pdf
subject
Published Version
Available under Creative Commons: BY 4.0

View Download

Atom BibTeX OpenURL ContextObject in Span OpenURL ContextObject Dublin Core MPEG-21 DIDL Data Cite XML EndNote HTML Citation METS MODS RIOXX2 XML Reference Manager Refer ASCII Citation
Export

Downloads