A qualitative study evaluating barriers and enablers to improving antimicrobial use for the management of bacteriuria in hospitalized adults

• DOI: 10.1017/ash.2024.13
• Publication Date: 2024-01-31T05:34:42Z
• Authors: Emily K. Black; Dianne MacLean; Madison Bell; Heather L. Neville; Olga Kits; Tasha D. Ramsey; Ingrid Sketris; Lynn Johnston
• Keywords: Thematic Analysis

Abstract Objective: The objective of this study was to explore barriers and enablers improving the management bacteriuria in hospitalized adults. Design: Qualitative study. Setting: Nova Scotia, Canada. Participants: Nurses, physicians, pharmacists involved assessment, diagnosis, treatment patients. Methods: Focus groups (FGs) were completed between May July 2019. FG discussions facilitated using an interview guide that consisted open-ended questions coded theoretical domains framework (TDF) v2. Discussions transcribed verbatim then independently TDFv2 by two members research team compared. Thematic analysis used identify themes. Results: Thirty-three healthcare providers from five hospitals participated (15 pharmacists, 11 nurses, 7 physicians). use antibiotics for asymptomatic (ASB) main issue identified. Subthemes related ASB included: “diagnostic uncertainty,” difficulty “ignoring positive urine cultures,” “organizational challenges,” “how people learn.” Barriers and/or mapped 12 within these subthemes. identified participants most extensively discussed environmental context resources, belief about capabilities , social/professional role identity social influences . Conclusions: Healthcare highlighted recognized may improve delivery care patients with bacteriuria. A wide range at individual organization level address diagnostic challenges workload should be considered