Staff turnover challenges care of UTIs, research finds

Over one in four care home residents are prescribed antibiotics on a just in case basis, but only eight per cent are taking them, according to new research published in an academic journal.

Researchers conclude that high staff turnover can make it a challenging “to maintain training levels and enforce good antimicrobial practice.” They say: “Provision of healthcare services for residents in long-term care facilities (LTCFs) is variable and can result in disjointed care between carers and NHS healthcare professionals.

The percentage of antibiotics prescribed for prophylactic use was 25.3 per cent, whereas for residents actually taking antibiotics on the day of the visit, the proportions were: 6.3 per cent in  England (536 LTCFs), 7.6 per cent Northern Ireland (35 LTCFs), 8.6 per cent Wales (10 LTCFs) and 9.6 per cent Scotland (63 LTCFs).

In the study, published in the Journal of Antimicrobial Chemotherapy, data were analysed for almost 18,000 residents (17, 909 residents) in 644 LTCFs across the UK.

The study has also identified workforce training as an issue: only 6.8 per cent of LTCFs had antibiotic training available, and 7.1 per cent of LTCFs reported use of a catheter passport scheme.  

Researchers say that residents in LTCFs are associated with higher rates of antibiotic use (compared with community-dwelling older people), particularly for urinary tract infections (UTIs), and that infections within this environment are associated with higher hospital admissions and readmissions. It is estimated that one in 14 people within the community are catheterized, and up to 60 per cent of UTIs are related to catheter insertion.

NHS improvement schemes in England currently focus on reducing inappropriate antibiotic prescribing by 50 per cent by 2021 and improving the primary care management of UTIs to reduce the risk of bloodstream infections. The catheter passport scheme was created to help support patients with their understanding and use of catheters, and healthcare professionals involved in their care.


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