{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T12:49:42Z","timestamp":1788439782607,"version":"build-2803163510"},"reference-count":161,"publisher":"National Institute for Health and Care Research","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment programme","doi-asserted-by":"publisher","award":["NIHR130396"],"award-info":[{"award-number":["NIHR130396"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journalslibrary.nihr.ac.uk"],"crossmark-restriction":false},"short-container-title":["Health Technol Assess"],"abstract":"<jats:sec id=\"abs1-1\"><jats:title>Background<\/jats:title>\n<jats:p>Urinary tract infection is the most diagnosed infection in older people. It accounts for more than 50% of antibiotic prescriptions in care homes and is a frequent reason for care home residents being hospitalised.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-2\"><jats:title>Objective<\/jats:title>\n<jats:p>This realist review developed and refined programme theories for preventing and recognising urinary tract infection, exploring what works, for whom and in what circumstances.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-3\"><jats:title>Design<\/jats:title>\n<jats:p>The review used realist synthesis to explore existing literature on the detection and prevention of urinary tract infection, complemented by stakeholder consultation. It applies to the UK context, although other healthcare systems may identify synergies in our findings.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-4\"><jats:title>Data sources<\/jats:title>\n<jats:p>Bibliographic databases searched included MEDLINE, CINAHL, EMBASE, Cochrane Library, Web of Science Core Collection (including the Social Sciences Citation Index), Sociological Abstracts, Bibliomap and National Institute for Health and Care Research Journals Library.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-5\"><jats:title>Data selection and extraction<\/jats:title>\n<jats:p>Title and abstract screening were undertaken by two researchers independently of each other. Selection and assessment were based on relevance and rigour and cross-checked by a second researcher. Data extracted from the included studies were explored for explanations about how the interventions were considered to work (or not). Evidence tables were constructed to enable identification of patterns across studies that offered insight about the features of successful interventions.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-6\"><jats:title>Data analysis and synthesis<\/jats:title>\n<jats:p>Programme theories were constructed through a four-stage process involving scoping workshops, examination of relevant extant theory, analysis and synthesis of primary research, teacher\u2013learner interviews and a cross-system stakeholder event. A process of abductive and retroductive reasoning was used to construct context\u2013mechanism\u2013outcome configurations to inform programme theory.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-7\"><jats:title>Results<\/jats:title>\n<jats:p>The scoping review and stakeholder engagement identified three theory areas that address the prevention and recognition of urinary tract infection and show what is needed to implement best practice. Nine context\u2013mechanism\u2013outcome configurations provided an explanation of how interventions to prevent and recognise urinary tract infection might work in care homes. These were (1) recognition of urinary tract infection is informed by skills in clinical reasoning, (2) decision-support tools enable a whole care team approach to communication, (3) active monitoring is recognised as a legitimate care routine, (4) hydration is recognised as a care priority for all residents, (5) systems are in place to drive action that helps residents to drink more, (6) good infection prevention practice is applied to indwelling urinary catheters, (7) proactive strategies are in place to prevent recurrent urinary tract infection, (8) care home leadership and culture fosters safe fundamental care and (9) developing knowledgeable care teams.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-8\"><jats:title>Limitations<\/jats:title>\n<jats:p>We adapted our approach and work to online interactions with stakeholders and as a research team because of COVID-19. This also had an impact on bringing stakeholders together at a face-to-face event at the end of the project. Studies focusing on the prevention of urinary tract infection in care home settings were predominantly from the USA and Europe where the regulatory and funding systems for the long-term care of the elderly have some differences, particularly in the USA where national reporting plays a significant role in driving improvements in care.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-9\"><jats:title>Conclusions<\/jats:title>\n<jats:p>Care home staff have a vital role in the prevention and recognition of urinary tract infection, which can be enabled through integration and prioritisation within the systems and routines of care homes and delivery of person-centred care. Promoting fundamental care as a means of facilitating a holistic approach to prevention and recognition of urinary tract infection helps staff to recognise how they can contribute to antimicrobial stewardship and recognition of sepsis. Challenging assumptions made by staff about the presentation of urinary tract infection is complex and requires education that facilitates \u2018unlearning\u2019 and questioning of low-value practices. Programmes to prevent urinary tract infection need to be co-designed and supported through active and visible leadership by care home managers with support from specialist practitioners.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-10\"><jats:title>Future work<\/jats:title>\n<jats:p>We will focus on co-designing tools that facilitate implementation of our findings to ensure they fit with the care home context and address some of the challenges faced by care home leaders. This will underpin action at care home and system levels. Further research is needed to better understand the perspectives of residents and family carers, the effectiveness of non-pharmacological, pharmacological and specialist practitioner interventions and non-traditional approaches to training and educating the workforce in care home settings.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-11\"><jats:title>Study registration<\/jats:title>\n<jats:p>This study is registered as PROSPERO CRD42020201782.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"abs1-12\"><jats:title>Funding<\/jats:title>\n<jats:p>This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: NIHR130396) and is published in full in <jats:italic>Health Technology Assessment<\/jats:italic>; Vol. 28, No. 68. See the NIHR Funding and Awards website for further award information.<\/jats:p>\n<\/jats:sec>","DOI":"10.3310\/dadt3410","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T16:44:41Z","timestamp":1729529081000},"page":"1-139","update-policy":"https:\/\/doi.org\/10.3310\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Strategies for older people living in care homes to prevent urinary tract infection: the StOP UTI realist synthesis"],"prefix":"10.3310","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5524-6775","authenticated-orcid":true,"given":"Jacqui","family":"Prieto","sequence":"first","affiliation":[{"name":"School of Health Sciences, University of Southampton, Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4713-9662","authenticated-orcid":true,"given":"Jennie","family":"Wilson","sequence":"additional","affiliation":[{"name":"Richard Wells Research Centre, University of West London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5557-8120","authenticated-orcid":true,"given":"Alison","family":"Tingle","sequence":"additional","affiliation":[{"name":"Richard Wells Research Centre, University of West London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5043-4187","authenticated-orcid":true,"given":"Emily","family":"Cooper","sequence":"additional","affiliation":[{"name":"Primary Care and Interventions Unit, HCAI, Fungal, AMR, AMU and Sepsis Division, UK Health Security Agency, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8037-5042","authenticated-orcid":true,"given":"Melanie","family":"Handley","sequence":"additional","affiliation":[{"name":"Centre for Public Health and Community Care, University of Hertfordshire, De Havilland Campus, Hatfield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3858-5625","authenticated-orcid":true,"given":"Jo","family":"Rycroft-Malone","sequence":"additional","affiliation":[{"name":"Faculty of Health and Medicine, Lancaster University, Lancaster, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9261-9350","authenticated-orcid":true,"given":"Jennifer","family":"Bostock","sequence":"additional","affiliation":[{"name":"Patient and Public Involvement, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynne","family":"Williams","sequence":"additional","affiliation":[{"name":"School of Medical and Health Sciences, Bangor University, Wales, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2259-8149","authenticated-orcid":true,"given":"Heather","family":"Loveday","sequence":"additional","affiliation":[{"name":"Richard Wells Research Centre, University of West London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6221","published-online":{"date-parts":[[2024,10]]},"reference":[{"key":"key2024102122064500_ref1-bib1","volume-title":"Care Home Stats: Number of Settings, Population & Workforce","author":"Munson","year":"2022"},{"key":"key2024102122064500_ref2-bib2","volume-title":"Care Homes and Estimating the Self-funding Population, England: 2021 to 2022","author":"Office for National Statistics"},{"key":"key2024102122064500_ref3-bib3","volume-title":"The State of the Adult Social Care Sector and Workforce in England","author":"Skills for Care","year":"2022"},{"key":"key2024102122064500_ref4-bib4","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1016\/j.jamda.2015.06.025","article-title":"Prevalence of frailty in nursing homes: a systematic review and meta-analysis","volume":"16","author":"Kojima","year":"2015","journal-title":"J Am Med Dir Assoc"},{"key":"key2024102122064500_ref5-bib5","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.nedt.2018.05.014","article-title":"I-Hydrate training intervention for staff working in a care home setting: an observational study","volume":"68","author":"Greene","year":"2018","journal-title":"Nurse Educ Today"},{"key":"key2024102122064500_ref6-bib6","doi-asserted-by":"crossref","first-page":"1820","DOI":"10.1016\/j.clnu.2018.07.020","article-title":"Improving hydration of care home residents by increasing choice and opportunity to drink: a quality improvement study","volume":"38","author":"Wilson","year":"2019","journal-title":"Clin Nutr"},{"key":"key2024102122064500_ref7-bib7","doi-asserted-by":"crossref","first-page":"l525","DOI":"10.1136\/bmj.l525","article-title":"Antibiotic management of urinary tract infection in elderly patients in primary care and its association with bloodstream infections and all-cause mortality: population-based cohort study","volume":"364","author":"Gharbi","year":"2019","journal-title":"BMJ"},{"key":"key2024102122064500_ref8-bib8","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1186\/1741-7015-9-57","article-title":"Predictive factors of urinary tract infections among the oldest old in the general population. A population-based prospective follow-up study","volume":"9","author":"Caljouw","year":"2011","journal-title":"BMC Med"},{"key":"key2024102122064500_ref10-bib10","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1016\/S1473-3099(18)30353-0","article-title":"Trends over time in Escherichia coli bloodstream infections, urinary tract infections, and antibiotic susceptibilities in Oxfordshire, UK, 1998\u20132016: a study of electronic health records","volume":"18","author":"Vihta","year":"2018","journal-title":"Lancet Infect Dis"},{"key":"key2024102122064500_ref11-bib11","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/j.jhin.2016.12.008","article-title":"Epidemiology of Escherichia coli bacteraemia in England: results of an enhanced sentinel surveillance programme","volume":"95","author":"Abernethy","year":"2017","journal-title":"J Hosp Infect"},{"key":"key2024102122064500_ref12-bib12","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1186\/s12877-019-1181-4","article-title":"Asymptomatic bacteriuria in older adults: the most fragile women are prone to long-term colonization","volume":"19","author":"Biggel","year":"2019","journal-title":"BMC Geriatr"},{"key":"key2024102122064500_ref13-bib13","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.idc.2013.10.004","article-title":"Diagnosis and management of urinary tract infection in older adults","volume":"28","author":"Rowe","year":"2014","journal-title":"Infect Clin North Am"},{"key":"key2024102122064500_ref14-bib14","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.jhin.2006.11.011","article-title":"Healthcare-associated infection among residents of long-term care facilities: a cohort and nested case-control study","volume":"65","author":"Eriksen","year":"2007","journal-title":"J Hosp Infect"},{"key":"key2024102122064500_ref15-bib15","first-page":"33","article-title":"Urinary tract infections in older adults residing in long-term care facilities","volume":"20","author":"Genao","year":"2012","journal-title":"Ann Long-Term Care"},{"key":"key2024102122064500_ref16-bib16","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/S0195-6701(13)60012-2","article-title":"epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England","volume":"86","author":"Loveday","year":"2014","journal-title":"J Hosp Infect"},{"key":"key2024102122064500_ref17-bib17","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1177\/1757177414532507","article-title":"Point prevalence survey of urinary catheterisation in care homes and where they were inserted, 2012","volume":"15","author":"McNulty","year":"2014","journal-title":"J Infect Prev"},{"key":"key2024102122064500_ref18-bib18","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/1471-2318-13-12","article-title":"Community acquired infections in older patients admitted to hospital from care homes versus the community: cohort study of microbiology and outcomes","volume":"13","author":"Marwick","year":"2013","journal-title":"BMC Geriatr"},{"key":"key2024102122064500_ref21-bib21","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/j.ajic.2016.09.015","article-title":"Implementing clinical guidelines to prevent catheter-associated urinary tract infections and improve catheter care in nursing homes: systematic review","volume":"45","author":"Gould","year":"2017","journal-title":"Am J Infect Control"},{"key":"key2024102122064500_ref22-bib22","volume-title":"Supporting Nurses in Care Homes","author":"Spilsbury","year":"2015"},{"key":"key2024102122064500_ref23-bib23","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1017\/S1463423618000105","article-title":"Recognition of the complexity facing residential care homes: a practitioner inquiry","volume":"19","author":"Dudman","year":"2018","journal-title":"Prim Health Care Res Dev"},{"key":"key2024102122064500_ref24-bib24","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jhin.2019.02.008","article-title":"Effectiveness and core components of infection prevention and control programmes in long-term care facilities: a systematic review","volume":"102","author":"Lee","year":"2019","journal-title":"J Hosp Infect"},{"key":"key2024102122064500_ref25-bib25","doi-asserted-by":"crossref","first-page":"365","DOI":"10.12788\/jhm.2724","article-title":"Systematic review of interventions to reduce urinary tract infection in nursing home residents","volume":"12","author":"Meddings","year":"2017","journal-title":"J Hosp Med"},{"key":"key2024102122064500_ref26-bib26","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1177\/1757177420901550","article-title":"A prevalence survey of patients with indwelling urinary catheters on district nursing caseloads in the United Kingdom: the Community Urinary Catheter Management (CCaMa) Study","volume":"21","author":"Prieto","year":"2020","journal-title":"J Infect Prev."},{"key":"key2024102122064500_ref27-bib27","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1038\/s41585-018-0106-x","article-title":"Nonantibiotic prevention and management of recurrent urinary tract infection","volume":"15","author":"Sihra","year":"2018","journal-title":"Nat Rev Urol"},{"key":"key2024102122064500_ref28-bib28","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1007\/s41999-019-00191-3","article-title":"Why are we misdiagnosing urinary tract infection in older patients? A qualitative inquiry and roadmap for staff behaviour change in the emergency department","volume":"10","author":"O\u2019Kelly","year":"2019","journal-title":"Eur Geriatr Med"},{"key":"key2024102122064500_ref29-bib29","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1186\/1471-2318-12-73","article-title":"Asymptomatic bacteriuria, antibiotic use, and suspected urinary tract infections in four nursing homes","volume":"12","author":"Phillips","year":"2012","journal-title":"BMC Geriatr"},{"key":"key2024102122064500_ref31-bib31","doi-asserted-by":"crossref","first-page":"e83","DOI":"10.1093\/cid\/ciz021","article-title":"Clinical practice guideline for the management of asymptomatic bacteriuria: 2019 update by the Infectious Diseases Society of America","volume":"68","author":"Nicolle","year":"2019","journal-title":"Clin Infect Dis"},{"key":"key2024102122064500_ref32-bib32","volume-title":"Diagnosis of Urinary Tract Infections Quick Reference Tool for Primary Care for Consultation and Local Adaption","author":"Public Health England","year":"2019"},{"key":"key2024102122064500_ref33-bib33","volume-title":"English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR)","author":"Public Health England","year":"2018"},{"key":"key2024102122064500_ref34-bib34","doi-asserted-by":"crossref","first-page":"e002007","DOI":"10.1136\/bmjopen-2012-002007","article-title":"Is secondary preventive care improving? Observational study of 10-year trends in emergency admissions for conditions amenable to ambulatory care","volume":"3","author":"Bardsley","year":"2013","journal-title":"BMJ Open"},{"key":"key2024102122064500_ref35-bib35","doi-asserted-by":"crossref","first-page":"2083","DOI":"10.1093\/jac\/dkz135","article-title":"Antimicrobial use in UK long-term care facilities: results of a point prevalence survey","volume":"74","author":"Thornley","year":"2019","journal-title":"J Antimicrob Chemother"},{"key":"key2024102122064500_ref36-bib36","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.jamda.2013.11.009","article-title":"Clinical uncertainties in the approach to long term care residents with possible urinary tract infection","volume":"15","author":"Nace","year":"2014","journal-title":"J Am Med Dir Assoc"},{"key":"key2024102122064500_ref38-bib38","volume-title":"Preventing Healthcare Associated Gram-negative Bloodstream Infections: An Improvement Resource","author":"NHS Improvement\/Public Health England","year":"2017"},{"key":"key2024102122064500_ref39-bib39","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.jhin.2019.08.016","article-title":"Increased fluid intake for the prevention of urinary tract infection in adults and children in all settings: a systematic review","volume":"104","author":"Fasugba","year":"2020","journal-title":"J Hosp Infect"},{"key":"key2024102122064500_ref40-bib40","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1258\/1355819054308530","article-title":"Realist review \u2013 a new method of systematic review designed for complex policy interventions","volume":"10","author":"Pawson","year":"2005","journal-title":"J Health Serv Res Policy"},{"key":"key2024102122064500_ref41-bib41","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/1748-5908-7-33","article-title":"Realist synthesis: illustrating the method for implementation research","volume":"7","author":"Rycroft-Malone","year":"2012","journal-title":"Implement Sci"},{"key":"key2024102122064500_ref42-bib42","doi-asserted-by":"crossref","first-page":"e005356","DOI":"10.1136\/bmjopen-2014-005356","article-title":"Improving skills and care standards in the support workforce for older people: a realist review","volume":"4","author":"Rycroft-Malone","year":"2014","journal-title":"BMJ Open"},{"key":"key2024102122064500_ref43-bib43","volume-title":"EVIDENT Guidance for Reviewing the Evidence: A Compendium of Methodological Literature and Websites","author":"Booth","year":"January 2015"},{"key":"key2024102122064500_ref44-bib44","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/1741-7015-11-21","article-title":"RAMESES publication standards: realist syntheses","volume":"11","author":"Wong","year":"2013","journal-title":"BMC Med"},{"key":"key2024102122064500_ref45-bib45","volume-title":"BMJ Qual Saf","author":"Prieto","year":"2024"},{"key":"key2024102122064500_ref46-bib46","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1002\/jrsm.1386","article-title":"The \u2018realist search\u2019: a systematic scoping review of current practice and reporting","volume":"11","author":"Booth","year":"2020","journal-title":"Res Syn Meth"},{"key":"key2024102122064500_ref47-bib47","volume-title":"Publish or Perish","author":"Harzing","year":"2007"},{"key":"key2024102122064500_ref48-bib48","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/s13012-015-0237-x","article-title":"What\u2019s in a mechanism? Development of a key concept in realist evaluation","volume":"10","author":"Dalkin","year":"2015","journal-title":"Implement Sci"},{"key":"key2024102122064500_ref49-bib49","doi-asserted-by":"crossref","first-page":"54","DOI":"10.7748\/ns.2017.e10735","article-title":"Developing effective and caring nurse-patient relationships","volume":"31","author":"Feo","year":"2017","journal-title":"Nurs Stand"},{"key":"key2024102122064500_ref50-bib50","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1080\/13645570600595314","article-title":"Digging for nuggets: how \u2018bad\u2019 research can yield \u2018good\u2019 evidence","volume":"9","author":"Pawson","year":"2006","journal-title":"Int J Soc Res Methodol"},{"key":"key2024102122064500_ref51-bib51","doi-asserted-by":"crossref","first-page":"e011964","DOI":"10.1136\/bmjopen-2016-011964","article-title":"Improving skills and care standards in the support workforce for older people: a realist synthesis of workforce development interventions","volume":"6","author":"Williams","year":"2016","journal-title":"BMJ Open"},{"key":"key2024102122064500_ref52-bib52","doi-asserted-by":"crossref","first-page":"86","DOI":"10.5153\/sro.2819","article-title":"The application of abductive and retroductive inference for the design and analysis of theory-driven sociological research","volume":"18","author":"Meyer","year":"2013","journal-title":"Sociol Res Online"},{"key":"key2024102122064500_ref53-bib53","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1037\/0003-066X.54.7.493","article-title":"Implementation intentions: strong effects of simple plans","volume":"54","author":"Gollwitzer","year":"1999","journal-title":"Am Psychol"},{"key":"key2024102122064500_ref55-bib55","article-title":"Oestrogens for preventing recurrent urinary tract infection in postmenopausal women","volume":"2","author":"Perrotta","year":"2008","journal-title":"Cochrane Database of Syst Rev"},{"key":"key2024102122064500_ref56-bib56","volume-title":"EAU Guidelines","author":"Bonkat"},{"key":"key2024102122064500_ref57-bib57","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1111\/j.1471-6712.2008.00680.x","article-title":"Early nonspecific signs and symptoms of infection in institutionalized elderly persons: perceptions of nursing assistants","volume":"24","author":"Tingstrom","year":"2010","journal-title":"Scand J Caring Sci"},{"key":"key2024102122064500_ref58-bib58","doi-asserted-by":"crossref","first-page":"bjgpopen20X101044","DOI":"10.3399\/bjgpopen20X101044","article-title":"Development of an information leaflet and diagnostic flow chart to improve the management of urinary tract infections in older adults: a qualitative study using the Theoretical Domains Framework","volume":"4","author":"Jones","year":"2020","journal-title":"BJGP Open"},{"key":"key2024102122064500_ref59-bib59","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/j.jamda.2020.06.053","article-title":"Nurse decision-making for suspected UTI infections in nursing homes: potential targets to reduce antibiotic overuse","volume":"22","author":"Beeber","year":"2021","journal-title":"J Am Med Dir Assoc"},{"key":"key2024102122064500_ref60-bib60","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hsdr08080","article-title":"A multifaceted intervention to reduce antimicrobial prescribing in care homes: a non-randomised feasibility study and process evaluation","volume":"8","author":"Hughes","year":"2020","journal-title":"Health Serv Deliv Res"},{"key":"key2024102122064500_ref61-bib61","doi-asserted-by":"crossref","first-page":"360","DOI":"10.3390\/antibiotics9060360","article-title":"Development of a tailored, complex intervention for clinical reflection and communication about suspected urinary tract infections in nursing home residents","volume":"9","author":"Arnold","year":"2020","journal-title":"Antibiotics"},{"key":"key2024102122064500_ref62-bib62","doi-asserted-by":"crossref","first-page":"83","DOI":"10.3390\/antibiotics10010083","article-title":"A qualitative investigation of the acceptability and feasibility of a urinary tract infection patient information leaflet for older adults and their carers","volume":"10","author":"Jones","year":"2021","journal-title":"Antibiotics"},{"key":"key2024102122064500_ref63-bib63","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/j.1471-6712.2012.00994.x","article-title":"Clinical decision-making process for early nonspecific signs of infection in institutionalised elderly persons: experience of nursing assistants","volume":"27","author":"Sund-Levander","year":"2013","journal-title":"Scand J Caring Sci"},{"key":"key2024102122064500_ref64-bib64","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1017\/ice.2018.281","article-title":"A recipe for antimicrobial stewardship success: using intervention mapping to develop a program to reduce antibiotic overuse in long-term care","volume":"40","author":"Chambers","year":"2019","journal-title":"Infect Control Hosp Epidemiol"},{"key":"key2024102122064500_ref65-bib65","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.1016\/S1473-3099(21)00001-3","article-title":"Effectiveness of a tailored intervention to reduce antibiotics for urinary tract infections in nursing home residents: a cluster, randomised controlled trial","volume":"21","author":"Arnold","year":"2021","journal-title":"Lancet Infect Dis"},{"key":"key2024102122064500_ref66-bib66","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1017\/ice.2019.9","article-title":"Antimicrobial stewardship in rural nursing homes: impact of interprofessional education and clinical decision tool implementation on urinary tract infection treatment in a cluster randomized trial","volume":"40","author":"Pasay","year":"2019","journal-title":"Infect Control Hosp Epidemiol"},{"key":"key2024102122064500_ref67-bib67","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1136\/bmj.38602.586343.55","article-title":"Effect of a multifaceted intervention on number of antimicrobial prescriptions for suspected urinary tract infections in residents of nursing homes: cluster randomised controlled trial","volume":"331","author":"Loeb","year":"2005","journal-title":"BMJ"},{"key":"key2024102122064500_ref68-bib68","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1186\/s12877-016-0255-9","article-title":"Impact of a decision-making aid for suspected urinary tract infection on antibiotic overuse in nursing homes","volume":"16","author":"McMaughan","year":"2016","journal-title":"BMC Geriatr"},{"key":"key2024102122064500_ref69-bib69","first-page":"1798","article-title":"Communication in a hospital by means of a standardised method","volume":"174","author":"Ydemann","year":"2012","journal-title":"Ugeskr Laeger"},{"key":"key2024102122064500_ref70-bib70","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1186\/s12877-022-02977-w","article-title":"Implementing an intervention to reduce use of antibiotics for suspected urinary tract infection in nursing homes: a qualitative study of barriers and enablers based on Normalization Process Theory","volume":"22","author":"Kousgaard","year":"2022","journal-title":"BMC Geriatr"},{"key":"key2024102122064500_ref71-bib71","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1002\/nop2.22","article-title":"Nurses\u2019 actions in response to nursing assistants\u2019 observations of signs and symptoms of infections among nursing home residents","volume":"2","author":"Allemann","year":"2015","journal-title":"Nurs Open"},{"key":"key2024102122064500_ref72-bib72","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2318-14-136","article-title":"Factors influencing antibiotic prescribing in long-term care facilities: a qualitative in-depth study","volume":"14","author":"van Buul","year":"2014","journal-title":"BMC Geriatr"},{"key":"key2024102122064500_ref73-bib73","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.4081\/jphr.2019.1533","article-title":"Decisional issues in antibiotic prescribing in French nursing homes: an ethnographic study","volume":"8","author":"Chaaban","year":"2019","journal-title":"J Public Health Res"},{"key":"key2024102122064500_ref74-bib74","volume":"9","author":"Downs","year":"2021","journal-title":"A complex intervention to reduce avoidable hospital admissions in nursing homes: a research programme including the BHiRCH-NH pilot cluster RCT. Programme Grants Appl Res"},{"key":"key2024102122064500_ref75-bib75","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1111\/j.1532-5415.2011.03333.x","article-title":"Interventions to reduce hospitalisations from nursing homes: evaluation of the INTERACT II collaborative quality improvement project","volume":"59","author":"Ouslander","year":"2011","journal-title":"J Am Geriatr Soc"},{"key":"key2024102122064500_ref76-bib76","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1136\/qshc.7.3.149","article-title":"Enabling the implementation of evidence based practice: a conceptual framework","volume":"7","author":"Kitson","year":"1998","journal-title":"Qual Health Care"},{"key":"key2024102122064500_ref77-bib77","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1177\/0170840612457617","article-title":"Inter-professional barriers and knowledge brokering in an organizational context: the case of healthcare","volume":"33","author":"Currie","year":"2012","journal-title":"Organ Stud"},{"key":"key2024102122064500_ref78-bib78","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.jinf.2018.06.012","article-title":"Diagnostic value of symptoms and signs for identifying urinary tract infection in older adult outpatients: systematic review and meta-analysis","volume":"77","author":"Gbinigie","year":"2018","journal-title":"J Infect"},{"key":"key2024102122064500_ref79-bib79","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.ajog.2017.12.231","article-title":"Diagnosis and treatment of urinary tract infections across age groups","volume":"219","author":"Chu","year":"2018","journal-title":"Am J Obstet Gynecol"},{"key":"key2024102122064500_ref80-bib80","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1093\/ageing\/16.4.201","article-title":"The atypical presentation of infection in old age","volume":"16","author":"Berman","year":"1987","journal-title":"Age Ageing"},{"key":"key2024102122064500_ref81-bib81","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12877-019-1049-7","article-title":"The scientific evidence for a potential link between confusion and urinary tract infection in the elderly is still confusing-a systematic literature review","volume":"19","author":"Mayne","year":"2019","journal-title":"BMC Geriatr"},{"key":"key2024102122064500_ref82-bib82","article-title":"Clinical symptoms, signs and tests for identification of impending and current water-loss dehydration in older people","volume":"4","author":"Hooper","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"key2024102122064500_ref83-bib83","doi-asserted-by":"crossref","first-page":"555","DOI":"10.3390\/nu3050555","article-title":"Dehydration influences mood and cognition: a plausible hypothesis?","volume":"3","author":"Benton","year":"2011","journal-title":"Nutrients"},{"key":"key2024102122064500_ref84-bib84","doi-asserted-by":"crossref","first-page":"22","DOI":"10.5770\/cgj.17.90","article-title":"Delirium, a symptom of UTI in the elderly: fact or fable? A systematic review","volume":"17","author":"Balogun","year":"2014","journal-title":"Can Geriatr J"},{"key":"key2024102122064500_ref85-bib85","doi-asserted-by":"crossref","first-page":"18","DOI":"10.7748\/nop.2017.e887","article-title":"Nursing care for people with delirium superimposed on dementia","volume":"29","author":"Pryor","year":"2017","journal-title":"Nurs Older People"},{"key":"key2024102122064500_ref88-bib88","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1007\/s40266-015-0252-2","article-title":"Antibiotic prescribing in long-term care facilities: a meta-synthesis of qualitative research","volume":"32","author":"Fleming","year":"2015","journal-title":"Drugs Aging"},{"key":"key2024102122064500_ref89-bib89","doi-asserted-by":"crossref","first-page":"e032185","DOI":"10.1136\/bmjopen-2019-032185","article-title":"Multifaceted intervention to reduce antimicrobial prescribing in care homes: a process evaluation of a UK-based non-randomised feasibility study","volume":"9","author":"Potter","year":"2019","journal-title":"BMJ Open"},{"key":"key2024102122064500_ref90-bib90","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1111\/jocn.13906","article-title":"Family involvement in timely detection of changes in health of nursing homes residents: a qualitative exploratory study","volume":"27","author":"Powell","year":"2018","journal-title":"J Clin Nurs"},{"key":"key2024102122064500_ref91-bib91","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hsdr09020","article-title":"Theory and practical guidance for effective de-implementation of practices across health and care services: a realist synthesis","volume":"9","author":"Burton","year":"2021","journal-title":"Health Serv Deliv Res"},{"key":"key2024102122064500_ref92-bib92","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1001\/jamainternmed.2015.6840","article-title":"Promoting patient centered counseling to reduce use of low-value diagnostic tests: a randomized clinical trial","volume":"176","author":"Fenton","year":"2016","journal-title":"JAMA Intern Med"},{"key":"key2024102122064500_ref93-bib93","doi-asserted-by":"crossref","first-page":"710","DOI":"10.3122\/jabfm.2016.06.160056","article-title":"Watchful waiting strategy may reduce low-value diagnostic testing","volume":"29","author":"May","year":"2016","journal-title":"J Am Board Fam Med"},{"key":"key2024102122064500_ref94-bib94","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1136\/bmj.322.7282.336","article-title":"Pragmatic randomised controlled trial of two prescribing strategies for childhood acute otitis media","volume":"322","author":"Little","year":"2001","journal-title":"BMJ"},{"key":"key2024102122064500_ref95-bib95","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1080\/00909882.2017.1320575","article-title":"Reducing unwarranted antibiotic use for pediatric acute otitis media: the influence of physicians\u2019 explanation and instruction on parent compliance with \u2018watchful waiting\u2019","volume":"45","author":"MacGeorge","year":"2017","journal-title":"J Appl Commun Res"},{"key":"key2024102122064500_ref96-bib96","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12877-018-0995-9","article-title":"Improving living and dying for people with advanced dementia living in care homes: a realist review of Namaste Care and other multisensory interventions","volume":"18","author":"Bunn","year":"2018","journal-title":"BMC Geriatr"},{"key":"key2024102122064500_ref97-bib97","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.jamda.2019.11.004","article-title":"Diagnosis, treatment, and prevention of urinary tract infections in post-acute and long-term care settings: a consensus statement from AMDA\u2019s Infection Advisory Subcommittee","volume":"21","author":"Ashraf","year":"2020","journal-title":"J Am Med Dir Assoc"},{"key":"key2024102122064500_ref98-bib98","volume-title":"Decision Aid for Diagnosis and Management of Suspected Urinary Tract Infection (UTI) in People Aged 65 Years and Over","author":"Scottish Antimicrobial Prescribing Group (SAPG), Health Improvement Scotland, NHS Scotland","year":"2021"},{"key":"key2024102122064500_ref100-bib100","doi-asserted-by":"crossref","first-page":"e1003336","DOI":"10.1371\/journal.pmed.1003336","article-title":"Antibiotic prescribing for lower UTI in elderly patients in primary care and risk of bloodstream infection: a cohort study using electronic health records in England","volume":"17","author":"Shallcross","year":"2020","journal-title":"PLOS Med"},{"key":"key2024102122064500_ref101-bib101","volume-title":"Treating Your Infection UTI Leaflet, for Older Adults and Those Who Care for Them. Version 2.4.","author":"TARGET","year":"2018"},{"key":"key2024102122064500_ref102-bib102","volume-title":"The IOU Study: Improving Outcomes of UTI Toolkit","author":"AMDA \u2013 The Society for Post-Acute and Long-Term Care Medicine"},{"key":"key2024102122064500_ref103-bib103","doi-asserted-by":"crossref","first-page":"2659","DOI":"10.1093\/jac\/dkr312","article-title":"Can a multifaceted educational intervention targeting both nurses and physicians change the prescribing of antibiotics to nursing home residents? A cluster randomized controlled trial","volume":"66","author":"Pettersson","year":"2011","journal-title":"J Antimicrob Chemother"},{"key":"key2024102122064500_ref104-bib104","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1001\/jamainternmed.2020.1256","article-title":"A multifaceted antimicrobial stewardship program for the treatment of uncomplicated cystitis in nursing home residents","volume":"180","author":"Nace","year":"2020","journal-title":"JAMA Intern Med"},{"key":"key2024102122064500_ref105-bib105","doi-asserted-by":"crossref","first-page":"c199","DOI":"10.1136\/bmj.c199","article-title":"Effectiveness of five different approaches in management of urinary tract infection: randomised controlled trial","volume":"340","author":"Little","year":"2010","journal-title":"BMJ"},{"key":"key2024102122064500_ref106-bib106","volume-title":"Diagnosis and Management of Urinary Tract Infections in Long Term Care Facilities: Clinical Practice Guideline","author":"Toward Optimized Practice (TOP) Working Group for Urinary Tract Infections in Long Term Care Facilities","year":"January 2015"},{"key":"key2024102122064500_ref107-bib107","volume-title":"Dignity and Nutrition for Older People: Review of Compliance","author":"Care Quality Commission (CQC)","year":"2011"},{"key":"key2024102122064500_ref108-bib108","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.clnu.2013.11.010","article-title":"The pathophysiology of fluid and electrolyte balance in the older adult surgical patient","volume":"33","author":"El-Sharkawy","year":"2014","journal-title":"Clin Nutr"},{"key":"key2024102122064500_ref109-bib109","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.mad.2013.11.009","article-title":"Water-loss dehydration and aging","volume":"136\u2013137","author":"Hooper","year":"2014","journal-title":"Mech Ageing Dev"},{"key":"key2024102122064500_ref110-bib110","first-page":"1459","article-title":"Scientific opinion on dietary reference values for water","volume":"8","author":"European Food Safety Authority (EFSA) Panel on Dietetic Products","year":"2010","journal-title":"EFSA J"},{"key":"key2024102122064500_ref111-bib111","doi-asserted-by":"crossref","first-page":"S22","DOI":"10.1111\/j.1753-4887.2005.tb00151.x","article-title":"Strategies for ensuring good hydration in the elderly","volume":"63","author":"Ferry","year":"2005","journal-title":"Nutr Rev"},{"key":"key2024102122064500_ref112-bib112","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1111\/j.1469-0691.2010.03262.x","article-title":"Trends among pathogens reported as causing bacteraemia in England, 2004\u20132008","volume":"17","author":"Wilson","year":"2011","journal-title":"Clin Microbiol Infect"},{"key":"key2024102122064500_ref113-bib113","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1001\/jamainternmed.2018.4204","article-title":"Effect of increased daily water intake in premenopausal women with recurrent urinary tract infections: a randomized clinical trial","volume":"178","author":"Hooton","year":"2018","journal-title":"JAMA Intern Med"},{"key":"key2024102122064500_ref114-bib114","doi-asserted-by":"crossref","first-page":"139","DOI":"10.12968\/nrec.2020.22.3.139","article-title":"Improving fluid consumption in older people in care homes: an exploration of the factors contributing to under-hydration","volume":"22","author":"Wilson","year":"2020","journal-title":"Nurs Resid Care"},{"key":"key2024102122064500_ref115-bib115","doi-asserted-by":"crossref","first-page":"1298","DOI":"10.12968\/bjon.2018.27.22.1298","article-title":"Drinking vessel preferences in older nursing home residents: optimal design and potential for increasing fluid intake","volume":"27","author":"Bak","year":"2018","journal-title":"Br J Nurs"},{"key":"key2024102122064500_ref116-bib116","doi-asserted-by":"crossref","first-page":"36","DOI":"10.22540\/JFSF-04-036","article-title":"Evaluating a hydration intervention (DRInK Up) to prevent urinary tract infection in care home residents: a mixed methods exploratory study","volume":"4","author":"Booth","year":"2019","journal-title":"J Frailty Sarcopenia Falls"},{"key":"key2024102122064500_ref117-bib117","doi-asserted-by":"crossref","first-page":"e000563","DOI":"10.1136\/bmjoq-2018-000563","article-title":"Reducing urinary tract infections in care homes by improving hydration","volume":"8","author":"Lean","year":"2019","journal-title":"BMJ Open Qual"},{"key":"key2024102122064500_ref118-bib118","first-page":"340","article-title":"Practice brief: a hydration initiative in a long-term care facility","volume":"34","author":"Long","year":"2013","journal-title":"Geriatr Nurs"},{"key":"key2024102122064500_ref119-bib119","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1136\/bmjqs-2012-001774","article-title":"Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review","volume":"23","author":"Meddings","year":"2014","journal-title":"BMJ Qual Saf"},{"key":"key2024102122064500_ref120-bib120","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1177\/14690446060070010701","article-title":"Is there an opportunity to reduce urinary catheter-related infections? Exploring variation in catheterisation rates in care homes","volume":"7","author":"McNulty","year":"2006","journal-title":"Br J Infect Control"},{"key":"key2024102122064500_ref121-bib121","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1086\/655133","article-title":"Systematic review and meta-analysis: reminder systems to reduce catheter-associated urinary tract infections and urinary catheter use in hospitalized patients","volume":"51","author":"Meddings","year":"2010","journal-title":"Clin Infect Dis"},{"key":"key2024102122064500_ref122-bib122","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/s13012-020-01001-2","article-title":"Reducing catheter-associated urinary tract infections: a systematic review of barriers and facilitators and strategic behavioural analysis of interventions","volume":"15","author":"Atkins","year":"2020","journal-title":"Implement Sci"},{"key":"key2024102122064500_ref123-bib123","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3390\/antibiotics9070419","article-title":"Optimising interventions for catheter-associated urinary tract infections (CAUTI) in primary, secondary and care home settings","volume":"9","author":"Wanat","year":"2020","journal-title":"Antibiotics"},{"key":"key2024102122064500_ref124-bib124","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1001\/jamainternmed.2017.1689","article-title":"A national implementation project to prevent catheter-associated urinary tract infection in nursing home residents","volume":"177","author":"Mody","year":"2017","journal-title":"JAMA Intern Med"},{"key":"key2024102122064500_ref125-bib125","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1016\/j.ajic.2017.07.006","article-title":"A national collaborative approach to reduce catheter-associated urinary tract infections in nursing homes: a qualitative assessment","volume":"45","author":"Krein","year":"2017","journal-title":"Am J Infect Control"},{"key":"key2024102122064500_ref126-bib126","first-page":"S213","article-title":"Nursing home leaders\u2019 views on catheter use and CAUTI as a quality and safety concern","volume":"63","author":"Sreedhara","year":"2015","journal-title":"J Am Geriatr Soc"},{"key":"key2024102122064500_ref127-bib127","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2334-14-13","article-title":"A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance","volume":"14","author":"Bell","year":"2014","journal-title":"BMC Infect Dis"},{"key":"key2024102122064500_ref128-bib128","first-page":"2","article-title":"Use of a continence nurse specialist in an extended care facility","volume":"25","author":"Klay","year":"2005","journal-title":"Urol Nurs"},{"key":"key2024102122064500_ref129-bib129","volume-title":"Leadership: Theory & Practice","author":"Northouse","year":"2021"},{"key":"key2024102122064500_ref130-bib130","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1111\/scs.12086","article-title":"The impact of work culture on quality of care in nursing homes: a review study","volume":"28","author":"Andr\u00e9","year":"2014","journal-title":"Scand J Caring Sci"},{"key":"key2024102122064500_ref131-bib131","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1186\/s13012-018-0811-0","article-title":"A realist process evaluation within the Facilitating Implementation of Research Evidence (FIRE) cluster randomised controlled international trial: an exemplar","volume":"13","author":"Rycroft-Malone","year":"2018","journal-title":"Implement Sci"},{"key":"key2024102122064500_ref132-bib132","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1186\/s12877-020-01706-5","article-title":"The influence of care home managers on the implementation of a complex intervention: findings from the process evaluation of a randomised controlled trial of dementia care mapping","volume":"20","author":"Kelley","year":"2020","journal-title":"BMC Geriatr"},{"key":"key2024102122064500_ref133-bib133","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1177\/0141076818803457","article-title":"An evaluation of a safety improvement intervention in care homes in England: a participatory qualitative study","volume":"111","author":"Marshall","year":"2018","journal-title":"J R Soc Med"},{"key":"key2024102122064500_ref134-bib134","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1186\/s12913-019-4662-4","article-title":"Exploring the role of external experts in supporting staff to implement psychosocial interventions in care home settings: results from the process evaluation of a randomized controlled trial","volume":"19","author":"Surr","year":"2019","journal-title":"BMC Health Serv Res"},{"key":"key2024102122064500_ref135-bib135","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1016\/j.jamda.2017.05.025","article-title":"What works to improve and manage fecal incontinence in care home residents living with dementia? A realist synthesis of the evidence","volume":"18","author":"Buswell","year":"2017","journal-title":"J Am Med Dir Assoc"},{"key":"key2024102122064500_ref136-bib136","doi-asserted-by":"crossref","first-page":"e0140711","DOI":"10.1371\/journal.pone.0140711","article-title":"A systematic review of interventions to change staff care practices in order to improve resident outcomes in nursing homes","volume":"10","author":"Low","year":"2015","journal-title":"PLOS One"},{"key":"key2024102122064500_ref137-bib137","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1093\/oxfordjournals.epirev.a036021","article-title":"Public Health Surveillance in the United States","volume":"10","author":"Thacker","year":"1988","journal-title":"Epidemiol Rev"},{"key":"key2024102122064500_ref138-bib138","first-page":"134","article-title":"Saving lives and reducing harm. A CAUTI reduction program","volume":"35","author":"Scanlon","year":"2017","journal-title":"Nurs Econ"},{"key":"key2024102122064500_ref139-bib139","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1136\/bmjqs-2018-008924","article-title":"Relationship between nursing home quality indicators and potentially preventable hospitalisation","volume":"28","author":"Xu","year":"2019","journal-title":"BMJ Qual Saf"},{"key":"key2024102122064500_ref140-bib140","doi-asserted-by":"crossref","first-page":"103905","DOI":"10.1016\/j.ijnurstu.2021.103905","article-title":"Understanding the staff behaviours that promote quality for older people living in long term care facilities: a realist review","volume":"117","author":"Haunch","year":"2021","journal-title":"Int J Nurs Stud"},{"key":"key2024102122064500_ref141-bib141","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1093\/ageing\/afn140","article-title":"Exploring reasons for variation in urinary catheterisation prevalence in care homes: a qualitative study","volume":"37","author":"McNulty","year":"2008","journal-title":"Age Ageing"},{"key":"key2024102122064500_ref142-bib142","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1136\/bmjqs-2017-006610","article-title":"Evaluation of the association between Nursing Home Survey on Patient Safety culture (NHSOPS) measures and catheter-associated urinary tract infections: results of a national collaborative","volume":"27","author":"Smith","year":"2018","journal-title":"BMJ Qual Saf"},{"key":"key2024102122064500_ref143-bib143","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1097\/PTS.0000000000000587","article-title":"The relationship between culture of safety and rate of adverse events in long-term care facilities","volume":"17","author":"Abusalem","year":"2019","journal-title":"J Patient Saf"},{"key":"key2024102122064500_ref144-bib144","doi-asserted-by":"crossref","first-page":"e003178","DOI":"10.1136\/bmjopen-2013-003178","article-title":"Explaining the barriers to and tensions in delivering effective healthcare in UK care homes: a qualitative study","volume":"3","author":"Robbins","year":"2013","journal-title":"BMJ Open"},{"key":"key2024102122064500_ref145-bib145","volume-title":"Care Certificate Workbook","author":"Skills for Care","year":"2022"},{"key":"key2024102122064500_ref146-bib146","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1177\/136140960501000104","article-title":"Making claims on nursing work: exploring the work of healthcare assistants and the implications for registered nurses' roles","volume":"10","author":"Spilsbury","year":"2005","journal-title":"J Res Nurs"},{"key":"key2024102122064500_ref147-bib147","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1093\/cid\/civ236","article-title":"Enhancing resident safety by preventing healthcare-associated infection: a national initiative to reduce catheter-associated urinary tract infections in nursing homes","volume":"61","author":"Mody","year":"2015","journal-title":"Clin Infect Dis"},{"key":"key2024102122064500_ref148-bib148","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1080\/1357628031000066651","article-title":"Changing practice in residential aged care using participatory methods","volume":"16","author":"Lindeman","year":"2003","journal-title":"Educ Health (Abingdon)"},{"key":"key2024102122064500_ref149-bib149","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1177\/0730888405284567","article-title":"Emotional labor and organized emotional care: conceptualizing nursing home care work","volume":"33","author":"Lopez","year":"2006","journal-title":"Work Occup"},{"key":"key2024102122064500_ref150-bib150","doi-asserted-by":"crossref","first-page":"34","DOI":"10.7748\/ns.30.36.34.s44","article-title":"Understanding reflective practice","volume":"30","author":"Nicol","year":"2016","journal-title":"Nurs Stand"},{"key":"key2024102122064500_ref151-bib151","volume-title":"The Code Professional Standards of Practice and Behaviour for Nurses, Midwives and Nursing Associates","author":"Nursing & Midwifery Council","year":"2015"},{"key":"key2024102122064500_ref152-bib152","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1054\/nedt.2000.0430","article-title":"Achieving change through reflective practice: closing the loop","volume":"20","author":"Page","year":"2000","journal-title":"Nurse Educ Today"},{"key":"key2024102122064500_ref153-bib153","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1177\/0898264315600689","article-title":"Shared decision-making in nursing homes: factors associated with the empowerment of direct care workers","volume":"28","author":"Yeatts","year":"2016","journal-title":"J Aging Health"},{"key":"key2024102122064500_ref154-bib154","volume-title":"Urinary Tract Infection (Recurrent): Antimicrobial Prescribing","author":"NICE Guideline"},{"key":"key2024102122064500_ref155-bib155","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1093\/ageing\/afy146","article-title":"Antibiotic prophylaxis and clinical outcomes among older adults with recurrent urinary tract infection: cohort study","volume":"48","author":"Ahmed","year":"2019","journal-title":"Age Ageing"},{"key":"key2024102122064500_ref156-bib156","doi-asserted-by":"crossref","DOI":"10.1002\/14651858.CD001209.pub2","article-title":"Antibiotics for preventing recurrent urinary tract infection in non-pregnant women","author":"Albert","year":"2004","journal-title":"Cochrane Database Syst Rev"},{"key":"key2024102122064500_ref157-bib157","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1016\/j.ajog.2016.07.040","article-title":"Nitrofurantoin vs other prophylactic agents in reducing recurrent urinary tract infections in adult women: a systematic review and meta-analysis","volume":"215","author":"Price","year":"2016","journal-title":"Am J Obstet Gynecol"},{"key":"key2024102122064500_ref158-bib158","volume-title":"Cochrane Database Syst Rev","author":"Schwenger","year":"2015"},{"key":"key2024102122064500_ref159-bib159","doi-asserted-by":"crossref","first-page":"6852","DOI":"10.1128\/AEM.05561-11","article-title":"Inhibition of Escherichia coli CFT073 fliC expression and motility by cranberry materials","volume":"77","author":"Hidalgo","year":"2011","journal-title":"Appl Environ Microbiol"},{"key":"key2024102122064500_ref160-bib160","doi-asserted-by":"crossref","first-page":"2028","DOI":"10.1111\/j.1532-5415.2010.03080.x","article-title":"Feasibility of cranberry capsule administration and clean-catch urine collection in long-term care residents","volume":"58","author":"Juthani-Mehta","year":"2010","journal-title":"J Am Geriatr Soc"},{"key":"key2024102122064500_ref161-bib161","volume-title":"Cochrane Database Syst Rev","author":"Jepson","year":"2012"},{"key":"key2024102122064500_ref162-bib162","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1007\/s00345-013-1091-6","article-title":"D-mannose powder for prophylaxis of recurrent urinary tract infections in women: a randomized clinical trial","volume":"32","author":"Kranj\u010dec","year":"2014","journal-title":"World J Urol"},{"key":"key2024102122064500_ref163-bib163","doi-asserted-by":"crossref","first-page":"265.e1","DOI":"10.1016\/j.ajog.2020.05.048","article-title":"D-mannose vs other agents for recurrent urinary tract infection prevention in adult women: a systematic review and meta-analysis","volume":"223","author":"Lenger","year":"2020","journal-title":"Am J Obstet Gynecol"},{"key":"key2024102122064500_ref164-bib164","doi-asserted-by":"crossref","first-page":"147","DOI":"10.4103\/iju.IJU_378_18","article-title":"The use of chemotherapeutic agents as prophylaxis for recurrent urinary tract infection in healthy nonpregnant women: a network meta-analysis","volume":"35","author":"Nalliah","year":"2019","journal-title":"Indian J Urol"},{"key":"key2024102122064500_ref165-bib165","doi-asserted-by":"crossref","first-page":"e528","DOI":"10.3399\/BJGP.2020.0833","article-title":"Use of methenamine hippurate to prevent urinary tract infections in community adult women: a systematic review and meta-analysis","volume":"71","author":"Bakhit","year":"2021","journal-title":"Br J Gen Pract"},{"key":"key2024102122064500_ref166-bib166","doi-asserted-by":"crossref","first-page":"e068229","DOI":"10.1136\/bmj-2021-0068229","article-title":"Alternative to prophylactic antibiotics for the treatment of recurrent urinary tract infections in women","volume":"376","author":"Harding","year":"2022","journal-title":"BMJ"},{"key":"key2024102122064500_ref167-bib167","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1016\/S0002-9378(99)70597-1","article-title":"A randomized, open, parallel-group study on the preventive effect of an estradiol-releasing vaginal ring (Estring) on recurrent urinary tract infections in postmenopausal women","volume":"180","author":"Eriksen","year":"1999","journal-title":"Am J Obstet Gynecol"},{"key":"key2024102122064500_ref168-bib168","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1097\/SPV.0000000000000749","article-title":"Vaginal estrogen for the prevention of recurrent urinary tract infection in postmenopausal women: a randomized clinical trial","volume":"27","author":"Ferrante","year":"2021","journal-title":"Female Pelvic Med Reconstr Surg"},{"key":"key2024102122064500_ref169-bib169","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1056\/NEJM199309093291102","article-title":"A controlled trial of intravaginal estriol in postmenopausal women with recurrent urinary tract infections","volume":"329","author":"Raz","year":"1993","journal-title":"N Engl J Med"},{"key":"key2024102122064500_ref170-bib170","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.1086\/374341","article-title":"Effectiveness of estriol-containing vaginal pessaries and nitrofurantoin macrocrystal therapy in the prevention of recurrent urinary tract infection in postmenopausal women","volume":"36","author":"Raz","year":"2003","journal-title":"Clin Infect Dis"}],"container-title":["Health Technology Assessment"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/njl-admin.nihr.ac.uk\/document\/download\/2046413","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.journalslibrary.nihr.ac.uk\/publications\/DADT3410\/DADT3410.xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/njl-admin.nihr.ac.uk\/document\/download\/2046413","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T16:45:28Z","timestamp":1729529128000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.journalslibrary.nihr.ac.uk\/hta\/DADT3410"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10]]},"references-count":161,"alternative-id":["10.3310\/DADT3410"],"URL":"https:\/\/doi.org\/10.3310\/dadt3410","relation":{},"ISSN":["2046-4924"],"issn-type":[{"value":"2046-4924","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10]]},"assertion":[{"value":"This content has been made freely available to all.","name":"free","label":"Free to read"},{"value":"09-2020","name":"contractual_start_date","label":"contractual_start_date","group":{"name":"article_history","label":"Article History"}},{"value":"11-2022","name":"editorial_review_begun","label":"editorial review begun","group":{"name":"article_history","label":"Article History"}},{"value":"03-2023","name":"accepted_for_publication","label":"Accepted for publication","group":{"name":"article_history","label":"Article History"}}]}}