Prof. Heather Loveday1, Ass Prof Jacqui Prieto2, Prof Jennie Wilson1, Ms Emily Cooper4, Dr Melanie Handley3, Ms Alison Tingle1
1University of West London, Ealing, United Kingdom
2University of Southampton, Southampton, United Kingdom
3University of West London, Ealing, United Kingdom
4University of Hertfordshire, Hatfield, United Kingdom
5UK Health Security Agency, Gloucester, United Kingdom
6University of West London, Ealing, United Kingdom
Introduction: The occurrence of a urinary tract infection (UTI) increases with age and is highest among those living in care homes in the UK. Several factors predispose older people to UTI and resistance to antibiotics used to treat UTI is now common. One third of admissions to hospital from care homes in the UK are due to UTI and emergency admissions to hospitals have increased markedly. Over-diagnosis of UTI is recognised as a problem in care homes, and it is not clear how complex diagnostic algorithms are understood and applied. Guidance, for preventing UTI in care homes is limited and fails to account for the context in which care is delivered or the challenges presented by residents with complex health needs. Systems that support early recognition of UTI by care home staff are critical to driving improvements in UTI prevention and improve resident experience.
Methods: A realist synthesis was conducted in four iterative stages: construction of a theoretical framework and initial programme theory(ies); the retrieval, review and synthesis of evidence; testing/refining programme theory(ies) and formulation of recommendations for the prevention and recognition of UTI in care home settings.
Results: Nine programme theories were developed in three key areas, strategies to prevent UTI/CAUTI; strategies to support the recognition of UTI/CAUTI; and making best practice happen.
Conclusion: We have produced unique recommendations that are relevant for care home settings, which we believe can be incorporated into policy, guidance and educational programmes to help reduce the incidence of UTI, recurrent UTI and CAUTI.
Biography: Professor of Evidence-based Healthcare, Director of Research at the Richard Wells Research Centre, and Director of the JBI Centre for Evidence-based Healthcare at the University of West London.
A national and international leader in the field of infection prevention and control and patient safety, Heather has been at the forefront of translational research and evaluation of implementation, and lead author of national evidence-based guidelines for the prevention of HCAI in England. She is widely published in the field of infection prevention and control practice and has served in a number of leadership roles in the Infection Prevention Society