Joint Chief Investigators: Dr. Jacqui Prieto (University of Southampton) and Professor Heather Loveday (University of West London).

The co-investigators are Professor Jennie Wilson, Alison Tingle (University of West London), Jennifer Bostock (PPI based in England), Simon Briscoe (University of Exeter), Dr. Lynne Williams (Bangor University), Dr. Melanie Handley (University of Hertfordshire) and Professor Jo Rycroft - Malone (University of Lancaster).

Background:

This research study is investigating what strategies for preventing urinary tract infection (UTI) are more likely to work for older people living in care homes.

The occurrence of UTI increases with age and is highest among those living in care homes. Guidance about strategies for preventing UTI in care homes is limited and does not account for the varying contexts in which care is delivered.

This study’s aim is to find out how and why different approaches to preventing and recognising UTI might work for older people in care home settings in a way that takes account of their complex needs and the care environment.

The study will use realist review methodology to develop an explanatory understanding of what it is about an intervention that supports or inhibits its successful implementation in preventing UTI among older people living in care homes. It will provide unique recommendations that are relevant for care home settings, which can be incorporated into policy, guidance and educational programmes to help guide successful delivery of future improvement programmes and research.

Ends: 2022.

Study aims

We will address the following review questions:

Preventing urinary tract infection (UTI) among older people with or without urinary catheters living in care homes: what works, for whom, why and in what circumstances?

What are the contextual factors and mechanisms that enable or disable interventions designed to support the prevention and recognition of UTI?

We aim to:

Derive explanatory evidence that describes how best to deliver interventions to prevent UTI and support its recognition in older people with and without a urinary catheter in care homes.

We will:

1. Identify UTI prevention interventions and approaches to recognising UTI from different care home environments and synthesise evidence of impact.

2. Identify the mechanisms through which these interventions and approaches deliver improvements to benefit the care of older people with or without a urinary catheter in care homes.

3. Investigate the contextual characteristics that mediate the potential impact of these mechanisms on clinical care standards for older people.

4. Develop an explanatory framework that synthesises the review findings of relevance to care homes for older people and identifies the active components of interventions.

5. Recommend improvements to guide the development and successful delivery of future programmes to prevent UTI in care homes for older people.

See Study web pages