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. 2025 Jun;43(2):500-509.
doi: 10.1080/02813432.2025.2463455. Epub 2025 Feb 11.

A shared approach to managing urinary tract infections in nursing homes improved perceived care quality, workload, and collaboration - a qualitative study

Sif Helene Arnold  1   2 , Melissa M W Thomsen  2 , Marius Brostrøm Kousgaard  1 , Jette Nygaard Jensen  2
Affiliations

A shared approach to managing urinary tract infections in nursing homes improved perceived care quality, workload, and collaboration - a qualitative study

Sif Helene Arnold et al. Scand J Prim Health Care. 2025 Jun.

Abstract

Background: In 2019, around 4.95 million global deaths were linked to bacterial antimicrobial resistance (AMR). Managing urinary tract infections (UTIs) in nursing homes involves prevention, diagnosis, and treatment. This is often complex and cause excessive antibiotic use, increasing AMR. Infection prevention and antimicrobial stewardship (AMS) are complementary strategies for reducing AMR. Studies show that nursing home staff can safely reduce antibiotic prescriptions for UTIs using these strategies and that cross-sectoral collaboration with general practice is important in UTI management. However, the impact of combining infection prevention with AMS and general practice is unknown.

Objective: To explore the perceived impact of a new cross-sectorial intervention combining prevention and AMS on UTI management in nursing homes.

Methods: The intervention included a 3-h seminar for general practice and nursing home staff, and a reflection sheet to assess residents. We held 9 seminars in the Capital Region of Denmark in 2022 and conducted 15 semi-structured online and phone interviews with participants.

Results: Our findings indicate that the intervention clarified workflows, encouraged nursing staff to adhere to agreements, and increased trust and respect between nursing homes and general practice. A reflection sheet was essential in linking planned changes to actual implementation. The sheet helped restructure UTI management, leading to perceived improved patient assessment and fewer UTI-related inquiries to general practice.

Conclusion: Our findings suggest that the intervention had a positive impact on experienced care quality, workload, and cross-sector collaboration. However, physical attendance at the seminar limits the large-scale implementation of the intervention.

Keywords: Antibiotics; antibiotic stewardship; cross-sector collaboration; infection prevention; nursing homes; primary care; urinary tract infections.

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Figure 1.
Similarities and differences of previous interventions (prevention intervention and diagnostic intervention) and ‘Yes, no, maybe’.
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References

    1. Murray CJL, Ikuta KS, Sharara F, et al. . Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet. 2022; 399(10325):629–655. doi: 10.1016/S0140-6736(21)02724-0. - DOI - PMC - PubMed
    1. O’Neill J. Tackling drug-resistant infections globally: final report and recommendations; 2016. The Review on Antimicrobial Resistance. Welcome Trust and HM Government. [Internet]. [cited 2024 May 13]. Available from: https://amr-review.org/sites/default/files/160525_Final%20paper_with%20c....
    1. Goossens H, Ferech M, Vander Stichele R, et al. . Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet. 2005;365(9459):579–587. doi: 10.1016/S0140-6736(05)17907-0. - DOI - PubMed
    1. Rowe TA, Juthani-Mehta M.. Diagnosis and management of urinary tract infection in older adults. Infect Dis Clin North Am. 2014;28(1):75–89. doi: 10.1016/j.idc.2013.10.004. - DOI - PMC - PubMed
    1. Pea F. Antimicrobial treatment of bacterial infections in frail elderly patients: the difficult balance between efficacy, safety and tolerability. Curr Opin Pharmacol. 2015;24:18–22. doi: 10.1016/j.coph.2015.06.006. - DOI - PubMed

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