StOP UTI
Strategies for Older People living in care homes to prevent Urinary Tract Infection (StOP UTI): a realist synthesis of the evidence
Strategies for Older People living in care homes to prevent Urinary Tract Infection (StOP UTI):
This research proposes a realist synthesis of existing evidence to produce evidence-informed programme theories identifying which strategies are effective (or not) in preventing older people in care homes from acquiring urinary tract infections (UTIs).
About the project
Urine infections are common in older people living in care homes and are often difficult to recognise because signs and symptoms, such as becoming confused, may look like other conditions such as dementia. This may result in over and under-treatment.
Over-treatment with repeated antibiotic use leads to resistance to antibiotics, which means that they may not work in the future. Under-treatment may increase the risk of kidney infection and other problems, including the need for hospital admission, life-threatening infection or even death due to sepsis.
Guidance and research on preventing urine infections in older people relate mainly to hospitals. We do not know enough about this in long-term care settings in the UK such as nursing and residential homes. We reviewed the evidence using a research approach called realist synthesis, focusing on how and why approaches to spotting and preventing urine infection in older people’s care may work, for whom and in what settings.
We also looked at the evidence about how to support change in long-term care settings to make things better.
Our initial theories about how these approaches may work were discussed with a range of people and groups who are directly affected by problems with urine infections in care homes through a workshop and interviews.
This included care home residents, their carers, members of the public, care home providers, care home staff and experts working in the field of older people’s care to test and refine the theories so that we can describe how, why and in what settings the approaches work.
Impact, research team and publications
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Impact
Our research is the start of a process of understanding what does work in the care home setting and identify where further research is needed. A report, summary and articles provide practical examples and recommendations relevant to care home staff, care home managers, researchers, educators, carers and relatives for use to improve the recognition and prevention of urine infection in older people’s long-term care and to plan further research to investigate them.
We are in the process of turning our findings into a range of different resources and digital communications with input from experts who support the adoption and spread of innovation, such as the Academic Health Sciences Network, for sharing via care home networks and associations.
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Research team members
Joint project leads:
- Professor Heather Loveday - Director of Research (UWL)
- Dr Jacqui Prieto (University of Southampton)
Co-applicants:
- Professor Jennie Wilson - Professor of Healthcare Epidemiology (UWL)
- Jennifer Bostock - Lay co-applicant
- Simon Briscoe (University of Exeter)
- Professor Jo Rycroft-Malone (Lancaster University)
- Dr Leah Jones (Public Health England)
- Dr Lynne Williams (Bangor University)
- Dr Melanie Handley (University of Hertfordshire)
- Dr Emily Cooper (Public Health England)
- Lois Woods (University of Southampton)
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Research publications
Additional information
- The research is funded by the National Institute of Health Research – Health Technology Assessment Programme (NIHR HTA). The NIHR HTA Programme funds research about the clinical and cost-effectiveness and broader impact of healthcare treatments and tests for those who plan, provide or receive care from NHS and social care services.
- More information about the study can be found via the Journal Library website.
- This study was completed in 2022.
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