Prieto, Jacqui, Wilson, Jennie ORCID: https://orcid.org/0000-0002-4713-9662, Tingle, Alison, Cooper, Emily, Handley, Melanie, Rycroft-Malone, Jo, Bostock, Jennifer and Loveday, Heather ORCID: https://orcid.org/0000-0003-2259-8149 (2024) Preventing urinary tract infection in older people living in care homes: the ‘StOP UTI’ realist synthesis. BMJ Quality and Safety.

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Abstract

ABSTRACT
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
context–mechanism–outcome 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.

Item Type:	Article
Identifier:	10.1136/bmjqs-2023-016967
Subjects:	Medicine and health > Health promotion and public health > Infection prevention
Depositing User:	Heather Loveday
Date Deposited:	14 Aug 2024 12:59
Last Modified:	04 Nov 2024 11:17
URI:	https://repository.uwl.ac.uk/id/eprint/12307

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