scholarly journals Barriers and facilitators of implementing an antimicrobial stewardship intervention for urinary tract infection in a long-term care facility

2021 ◽  
pp. 171516352198975
Author(s):  
April J. Chan ◽  
Denis O’Donnell ◽  
Benjamin Kaasa ◽  
Annalise Mathers ◽  
Alexandra Papaioannou ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antimicrobial Stewardship ◽  
Long Term Care ◽  
External Factors ◽  
Barriers And Facilitators ◽  
Antibiotic Prescribing ◽  
Term Care

Background: Fifty percent of antibiotic courses in long-term care facilities (LTCFs) are unnecessary, leading to increased risk of harm. Most studies to improve antibiotic prescribing in LTCFs showed modest and unsustained results. We aimed to identify facilitators, barriers and strategies in implementing a urinary tract infection (UTI)–focused antimicrobial stewardship (AS) intervention at a LTCF, with the secondary objective of exploring the pharmacist’s potential roles. Methods: The study used a qualitative descriptive design. Participants attended either a focus group or one-on-one interview. Data were analyzed inductively using a codebook modified in an iterative analytic process. Barrier and facilitator themes were mapped using the capability, opportunity, motivation and behaviour (COM-B) model. Similarly, themes were identified from the transcripts regarding the pharmacist’s roles. Results: Sixteen participants were interviewed. Most barriers and facilitators mapped to the opportunities domain of the COM-B model. The main barrier themes were lack of access, lack of knowledge, ineffective communication, lack of resources and external factors, while the main facilitator themes were education, effective collaboration, good communication, sufficient resources and access. For the pharmacist’s role, the barrier themes were ineffective collaboration and communication. Conclusion: This study supports the importance of tailoring interventions to target factors underlying barriers to behaviour change. At this LTCF, an effective antimicrobial stewardship intervention should incorporate strategies to improve access, knowledge, communication and collaboration in its design, having sufficient resources and addressing external factors to optimize its success and long-term sustainability. Can Pharm J (Ott) 2021;154:xx-xx.

scholarly journals 2046. A Qualitative Study on Perceived Barriers and Facilitators of Implementing an Antimicrobial Stewardship Intervention in the Management of Urinary Tract Infections in a Long-Term Care Setting

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S688-S689
Author(s):  
April Chan ◽  
Denis O’Donnell ◽  
Benjamin Kaasa ◽  
Annalise Mathers ◽  
Nicoleta Paraschiv ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Antimicrobial Stewardship ◽  
Long Term Care ◽  
Structured Interview ◽  
Barriers And Facilitators ◽  
Antibiotic Prescribing ◽  
Term Care ◽  
Increased Risk ◽  
Tract Infections

Abstract Background 50% of antibiotic courses in long-term care facilities (LTCFs) are unnecessary, leading to increased risk of harm such as Clostridiodes difficile infection and antibiotic-resistant organisms. Antimicrobial stewardship (AS) interventions play an important role in optimizing antibiotic use. Most studies addressing strategies to improve antibiotic prescribing in LTCFs showed modest and unsustained results. We aimed to identify facilitators, barriers and strategies in implementing a urinary tract infection (UTI)-focused AS intervention at an LTCF in Toronto. Methods A qualitative approach using conventional content analysis was used. Through purposeful sampling, we recruited different LTCF healthcare providers and administrators at Kensington Gardens. Interviewees attended focus groups or one-on-one interviews. Data were collected using a semi-structured interview guide. Data were analyzed inductively using a codebook modified in an iterative analytic process. Barriers and facilitators with potential strategies were summarized and mapped using the COM-B (capability, opportunity, motivation and behavior) model (Mitchie et al.) and emerging themes identified. Results Sixteen participants were interviewed. The most common barriers were family pressure, lack of access and test result delay while the barrier themes were lack of access, inadequate communication, lack of time and lack of knowledge of both HCPs and resident’s families. These can be addressed by the most common facilitators and facilitator themes, which included good communication between healthcare professionals (HCPs), education for HCPs and families and collaboration between HCPs. Most barriers and facilitators were mapped to the opportunities domain of the COM-B model. Conclusion Strategies for improved UTI-focused antimicrobial stewardship intervention in LTC setting should focus on increasing opportunities and innovative formats for education, communication and collaboration among HCPs and with families although barriers and facilitators in all aspects of the COM-B model were identified. Disclosures All authors: No reported disclosures.

scholarly journals Evaluation of Urinary Tract Infection Testing and Treatment to Guide Antimicrobial Stewardship in the Long-Term Care Facility

2015 ◽  
Vol 2 (suppl_1) ◽  
Author(s):  
Cathleen Concannon ◽  
Gail Quinlan ◽  
Christina Felsen ◽  
Elizabeth Dodds Ashley ◽  
Kavita K. Trivedi ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antimicrobial Stewardship ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

scholarly journals 879Systematic Review of Interventions to Reduce Catheter-Associated Urinary Tract Infection in the Long-Term Care Setting

2014 ◽  
Vol 1 (suppl_1) ◽  
pp. S252-S253
Author(s):  
Jennifer Meddings ◽  
Sanjay Saint ◽  
Sarah Krein ◽  
Andy Hickner ◽  
Heidi Reichert ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Care Setting ◽  
Long Term Care ◽  
Term Care

scholarly journals A recipe for antimicrobial stewardship success: Using intervention mapping to develop a program to reduce antibiotic overuse in long-term care

2018 ◽  
Vol 40 (1) ◽  
pp. 24-31 ◽  
Author(s):  
Andrea Chambers ◽  
Sam MacFarlane ◽  
Rosemary Zvonar ◽  
Gerald Evans ◽  
Julia E. Moore ◽  
...  
Keyword(s):  
Behavior Change ◽  
Antimicrobial Stewardship ◽  
Long Term Care ◽  
Asymptomatic Bacteriuria ◽  
Barriers And Facilitators ◽  
Antibiotic Prescribing ◽  
Term Care ◽  
Antibiotic Overuse ◽  
Tract Infections

AbstractObjectiveTo better understand barriers and facilitators that contribute to antibiotic overuse in long-term care and to use this information to inform an evidence and theory-informed program.MethodsInformation on barriers and facilitators associated with the assessment and management of urinary tract infections were identified from a mixed-methods survey and from focus groups with stakeholders working in long-term care. Each barrier or facilitator was mapped to corresponding determinants of behavior change, as described by the theoretical domains framework (TDF). The Rx for Change database was used to identify strategies to address the key determinants of behavior change.ResultsIn total, 19 distinct barriers and facilitators were mapped to 8 domains from the TDF: knowledge, skills, environmental context and resources, professional role or identity, beliefs about consequences, social influences, emotions, and reinforcements. The assessment of barriers and facilitators informed the need for a multifaceted approach with the inclusion of strategies (1) to establish buy-in for the changes; (2) to align organizational policies and procedures; (3) to provide education and ongoing coaching support to staff; (4) to provide information and education to residents and families; (5) to establish process surveillance with feedback to staff; and (6) to deliver reminders.ConclusionsThe use of a stepped approach was valuable to ensure that locally relevant barriers and facilitators to practice change were addressed in the development of a regional program to help long-term care facilities minimize antibiotic prescribing for asymptomatic bacteriuria. This stepped approach provides considerable opportunity to advance the design and impact of antimicrobial stewardship programs.

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