2046. A Qualitative Study on Perceived Barriers and Facilitators of Implementing an Antimicrobial Stewardship Intervention in the Management of Urinary Tract Infections in a Long-Term Care Setting
Bibliographic record
Abstract
Abstract Background 50% of antibiotic courses in long-term care facilities (LTCFs) are unnecessary, leading to increased risk of harm such as Clostridiodes difficile infection and antibiotic-resistant organisms. Antimicrobial stewardship (AS) interventions play an important role in optimizing antibiotic use. Most studies addressing strategies to improve antibiotic prescribing in LTCFs showed modest and unsustained results. We aimed to identify facilitators, barriers and strategies in implementing a urinary tract infection (UTI)-focused AS intervention at an LTCF in Toronto. Methods A qualitative approach using conventional content analysis was used. Through purposeful sampling, we recruited different LTCF healthcare providers and administrators at Kensington Gardens. Interviewees attended focus groups or one-on-one interviews. Data were collected using a semi-structured interview guide. Data were analyzed inductively using a codebook modified in an iterative analytic process. Barriers and facilitators with potential strategies were summarized and mapped using the COM-B (capability, opportunity, motivation and behavior) model (Mitchie et al.) and emerging themes identified. Results Sixteen participants were interviewed. The most common barriers were family pressure, lack of access and test result delay while the barrier themes were lack of access, inadequate communication, lack of time and lack of knowledge of both HCPs and resident’s families. These can be addressed by the most common facilitators and facilitator themes, which included good communication between healthcare professionals (HCPs), education for HCPs and families and collaboration between HCPs. Most barriers and facilitators were mapped to the opportunities domain of the COM-B model. Conclusion Strategies for improved UTI-focused antimicrobial stewardship intervention in LTC setting should focus on increasing opportunities and innovative formats for education, communication and collaboration among HCPs and with families although barriers and facilitators in all aspects of the COM-B model were identified. Disclosures All authors: No reported disclosures.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".