Please use this identifier to cite or link to this item: http://hdl.handle.net/10553/134380
Title: Improving antibiotic use in nursing homes by infection prevention and control and antibiotic stewardship (IMAGINE): protocol for a before-and-after intervention and implementation study
Authors: Garcia-Sangenis, Ana
Modena, Daniela
Jensen, Jette Nygaard
Chalkidou, Athina
Antsupova, Valeria S.
Marloth, Tina
Theut, Anna Marie
González Lopez-Valcarcel, Beatriz 
Raynal, Fabiana
Vallejo Torres, Laura 
Lykkegaard, Jesper
Hansen, Malene Plejdrup
Sondergaard, Jens
Olsen, Jonas Kanstrup
Munck, Anders
Balint, Andras
Benko, Ria
Petek, Davorina
Sodja, Nina
Kowalczyk, Anna
Godycki-Cwirko, Maciej
Glasova, Helena
Glasa, Jozef
Jurgute, Ruta Radzeviciene
Jaruseviciene, Lina
Lionis, Christos
Anastasaki, Marilena
Angelaki, Agapi
Petelos, Elena
Alvarez, Laura
Ricart, Marta
Briones, Sergi
Ruppe, Georg
Monfa, Ramon
Bjerrum, Anders
Llor, Carl
UNESCO Clasification: 531207 Sanidad
Keywords: Prescription
Antimicrobial Stewardship
Medical Audit
Hygiene
Antibacterial Agents, et al
Issue Date: 2024
Project: Improving antibiotic use in long term care facilities by infection prevention and control and antibiotic stewardship 
Journal: Jmir Research Protocols 
Abstract: Background: Despite the extensive use of antibiotics and the growing challenge of antimicrobial resistance, there has been alack of substantial initiatives aimed at diminishing the prevalence of infections in nursing homes and enhancing the detection of urinary tract infections (UTIs).Objective: This study aims to systematize and enhance efforts to prevent health care-associated infections, mainly UTIs and reduce antibiotic inappropriateness by implementing a multifaceted intervention targeting health care professionals in nursing homes. Methods: A before-and-after intervention study carried out in a minimum of 10 nursing homes in each of the 8 European participating countries (Denmark, Greece, Hungary, Lithuania, Poland, Slovakia, Slovenia, and Spain). A team of 4 professionals consisting of nurses, doctors, health care assistants, or health care helpers are actively involved in each nursing home. Over the initial 3-month period, professionals in each nursing home are registering information on UTIs as well as infection and prevention control measures by means of the Audit Project Odense method. The audit will be repeated after implementing a multifaceted intervention. The intervention will consist of feedback and discussion of the results from the first registration, training on the implementation of infection and prevention control techniques provided by experts, appropriateness of the diagnostic approach and antibiotic prescribing for UTIs, and provision of information materials on infection control and antimicrobial stewardship targeted to staff, residents, and relatives. We will compare the pre- and postintervention audit results using chi-square test for prescription appropriateness and Student t test for implemented hygiene elements. Results: A total of 109 nursing homes have participated in the pilot study and the first registration audit. The results of the first audit registration are expected to be published in autumn of 2024. The final results will be published by the end of 2025.Conclusions: This is a European Union-funded project aimed at contributing to the battle against antimicrobial resistance through improvement of the quality of management of common infections based on evidence-based interventions tailored to the nursing home setting and a diverse range of professionals. We expect the intervention to result in a significant increase in the number of hygiene activities implemented by health care providers and residents. Additionally, we anticipate a marked reduction in the number of inappropriately managed UTIs, as well as a substantial decrease in the overall incidence of infections following the intervention. International Registered Report Identifier (IRRID): DERR1-10.2196/60099
URI: http://hdl.handle.net/10553/134380
ISSN: 1929-0748
DOI: 10.2196/60099
Source: Jmir Research Protocols[ISSN 1929-0748],v. 13, (2024)
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