About: The Impact of Healthcare Provider Relationships and Communication Dynamics on Urinary Tract Infection Management and Antibiotic Utilization for Long-Term Care Facility Residents Treated in the Emergency Department: A Qualitative Study

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About: The Impact of Healthcare Provider Relationships and Communication Dynamics on Urinary Tract Infection Management and Antibiotic Utilization for Long-Term Care Facility Residents Treated in the Emergency Department: A Qualitative Study Goto Sponge NotDistinct Permalink

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	The Impact of Healthcare Provider Relationships and Communication Dynamics on Urinary Tract Infection Management and Antibiotic Utilization for Long-Term Care Facility Residents Treated in the Emergency Department: A Qualitative Study
Creator	Bs, Elizabeth Bs, Valmadrid Carmichael, Luke Pulia, Michael Schwei, Rebecca
Source	Elsevier; Medline; PMC
abstract	BACKGROUND: : For older adults, over diagnosis of urinary tract infections (UTI) is a primary driver of inappropriate antibiotic use. This risk is increased for patients in long term care facilities (LTCF), especially as they transition back and forth to emergency departments (ED). In this study, we aimed to understand how healthcare provider communication and relationship dynamics affect LTCF residents treated in the ED to identify barriers to antibiotic stewardship for UTIs. METHODS: : We conducted semi-structured interviews with nurses and physicians from LTCFs and EDs, guided by the Systems Engineering Initiative for Patient Safety framework. Data were systematically coded and underwent iterative, conventional content analysis. RESULTS: : We interviewed 16 LTCF and 16 ED providers across Wisconsin. ED and LTCF nurses have a critical role in both intrafacility and interfacility communication. Fragmented communication and interprofessional power dynamics were identified barriers to optimal antibiotic prescribing for UTIs. Identified strategies to overcome these issues included using objective diagnostic criteria, development of communication scripts and nurse-to-nurse education. CONCLUSIONS: : Our qualitative approach revealed important insights about how communication and relationship dynamics influence UTI diagnosis and optimal antibiotic stewardship for LTCF residents evaluated in the ED. Future interventions should strengthen communications between settings and across provider types, and address standardization of diagnostic and treatment communication pathways for LTCF residents with suspected infections transitioning between EDs and LTCFs.
has issue date	2020-07-10(xsd:dateTime)
bibo:doi	10.1016/j.ajic.2020.07.009
bibo:pmid	32653562
has license	no-cc
sha1sum (hex)	232ec5231d39ba980d6ba9537271596c937e7cf0
schema:url	https://doi.org/10.1016/j.ajic.2020.07.009
resource representing a document's title	The Impact of Healthcare Provider Relationships and Communication Dynamics on Urinary Tract Infection Management and Antibiotic Utilization for Long-Term Care Facility Residents Treated in the Emergency Department: A Qualitative Study
has PubMed Central identifier	PMC7348612
has PubMed identifier	32653562
schema:publication	Am J Infect Control
resource representing a document's body	covid:232ec5231d39ba980d6ba9537271596c937e7cf0#body_text
is schema:about of	named entity 'urinary tract infections' named entity 'Background' named entity 'settings' named entity 'Utilization' named entity 'Communication' named entity 'DIAGNOSIS' named entity 'TO IDENTIFY' named entity 'UNDERSTAND' named entity 'URINARY TRACT INFECTIONS' named entity 'HOW' named entity 'ANTIBIOTIC USE' named entity 'residents' named entity 'primary' named entity 'healthcare provider' named entity 'patients' named entity 'affect' named entity 'Facility' named entity 'LTCF' named entity 'long term care facilities' named entity 'power dynamics' named entity 'long-term care' named entity 'UTI' named entity 'Urinary tract' named entity 'study population' named entity 'nursing homes' named entity 'antibiotic stewardship' named entity 'nurse education' named entity 'EDs' named entity 'antibiotic' named entity 'UTIs' named entity 'Asymptomatic bacteriuria' named entity 'personal relationships' named entity 'antibiotic stewardship' named entity 'Wisconsin' named entity 'qualitative research' named entity 'antibiotics' named entity 'antibiotic' named entity 'antibiotic' named entity 'asymptomatic bacteriuria' named entity 'misdiagnosis' named entity 'nursing staff' named entity '60 minutes' named entity 'antibiotic stewardship' named entity 'antibiotic' named entity 'belittle' named entity 'decision-making' named entity 'antibiotics' named entity 'infection' named entity 'emergency physician' named entity 'UTIs' named entity 'older adults' named entity 'UTIs' named entity 'long-term care facilities' named entity 'Nursing Homes' named entity 'geriatric' named entity 'CMS' named entity 'antibiotic' named entity 'high-risk' named entity 'Altered mental status' named entity 'infection' named entity 'demographic' named entity 'antibiotics' named entity 'infection' named entity 'diagnostic criteria' named entity 'antibiotic stewardship' named entity 'UTIs' named entity 'antibiotic stewardship' named entity 'skilled nursing facility' named entity 'antibiotic' named entity 'probability' named entity 'clinical experience' named entity 'transcription' named entity 'data analysis' named entity 'skilled nursing' named entity 'Wisconsin' named entity 'antibiotics' named entity 'antimicrobial stewardship'

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