A multifaceted intervention reduced antimicrobial prescriptions for suspected urinary tract infections in nursing home residents
Q Does a multifaceted intervention supporting the use of diagnostic and treatment algorithms reduce antimicrobial prescriptions for suspected urinary tract infections (UTIs) in nursing home residents?
METHODS
Design:
clustered randomised controlled trial.
Allocation:
concealed.
Blinding:
blinded (outcome assessors).
Follow up period:
12 months.
Setting:
16 nursing homes in Ontario, Canada and 8 in Idaho, USA.
Patients:
4217 residents of 24 free standing, community based nursing homes that had ⩾100 residents, no stated policies for diagnosis or treatment of UTIs, and agreed to refrain from introducing new management strategies for antimicrobial use or clinical pathways for UTIs during the 12 month study. Nursing homes directly associated with tertiary care centres were excluded.
Intervention:
12 nursing homes (2156 residents) were allocated to the intervention, which comprised introduction of UTI diagnostic and treatment algorithms in 30 minute, interactive, small group sessions for registered nurses or nursing assistants (videotaped for subsequent viewing …
