Factors influencing urinary tract infection prevention and antibiotic stewardship in European nursing homes: an interview study with staff

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PURPOSE: To explore the perceptions of European nursing home staff regarding factors influencing the prevention of urinary tract infections and antimicrobial stewardship. METHODS: This qualitative descriptive study was conducted between July and September 2023. In each of eight European countries-Denmark, Greece, Hungary, Lithuania, Poland, Slovakia, Slovenia, and Spain-five semi-structured interviews were carried out with nursing home staff, resulting in a total of 40 interviews. All interviews were audio-recorded, transcribed verbatim, and analyzed using systematic text condensation. RESULTS: Factors perceived to influence infection prevention and antibiotic stewardship were organized into five themes: (1) residents, including the respect for their autonomy, (2) relatives, including their demands for investigations and treatment, (3) physicians, including their attitudes towards antibiotics, (4) staff, including their challenging working conditions and lack of education, and (5) the nursing home environment in which these four actors navigate. CONCLUSION: Nursing home staff perceive multiple factors influencing infection prevention, including the challenge of balancing respect for residents' autonomy with maintaining high hygiene standards. A key barrier to effective antimicrobial stewardship appears to be a lack of staff awareness regarding their crucial role in the process.

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