Use this URL to cite or link to this record in EThOS: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.579743
Title: Antimicrobial prescribing and infection control in care homes for older people
Author: McClean, Pamela
Awarding Body: Queen's University Belfast
Current Institution: Queen's University Belfast
Date of Award: 2012
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Abstract:
Introduction: Antimicrobial prescribing has been reported to be sub-optimal in care homes; however, prior to this research there was no information in relation to antimicrobial use in Northern Ireland's (NI's) care homes. Furthermore, the factors having an impact on infection control practices in NI's care homes had not been identified. Methods: Two point prevalence surveys (PPS) were conducted in 30 nursing homes and 30 residential homes, to determine the prevalence of antimicrobial prescribing and any associations with resident or institutional factors. Findings from the PPS in nursing homes informed the development of a pilot intervention study for the management of urinary tract infections (UTIs). Qualitative research was conducted to investigate the experience of nursing home staff who were involved in a previous infection control education and training intervention study and to explore the feasibility of introducing widespread Meticillin-resistant Staphylococcus aureus (MRSA) decolonisation to the nursing home setting. Appropriate quantitative and qualitative analyses were performed for all studies. Results: The PPS identified a high rate of antimicrobial prescribing in nursing (April 2009, l3%; November 2009, 11%) and residential homes (November 2010, 9%; April 2011, 9%) with variability evident both within and between homes. Antimicrobials were most frequently prescribed for UTIs. In the pilot UTI intervention study, fewer (-38%) antimicrobials were prescribed and fewer (-7%) residents were treated for suspected UTIs. However, the number of urine dipstick tests and urine samples which were sent to the laboratory remained high. The qualitative study found that the factors influencing infection control and MRSA decolonisation in nursing homes were organisational (e.g. time, financial resources, environmental, management and culture); external (e.g. hospitals and general practitioners); and residents and families. Conclusion: The four studies have shown that care homes require further support to optimise antimicrobial prescribing, the management of UTIs and infection control
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.579743  DOI: Not available
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