Assignment: Antibiotic Prescribing

Want create site? With you can do it easy.

SYSTEMATIC REVIEW

Antibiotic Prescribing in Long-Term Care Facilities: A Meta-synthesis of Qualitative Research

Don't use plagiarized sources. Get Your Custom Essay on
Assignment: Antibiotic Prescribing
Just from $13/Page
Order Essay

Aoife Fleming1 • Colin Bradley2 • Shane Cullinan1 • Stephen Byrne1

Published online: 2 April 2015

� The Author(s) 2015. This article is published with open access at Springerlink.com

Abstract

Objectives The objective of this review was to synthesize

the findings of qualitative studies investigating the factors

influencing antibiotic prescribing in long-term care facilities

(LTCFs). These findings will inform the development of fu-

ture antimicrobial stewardship strategies (AMS) in this setting.

Methods We searched Embase, PubMed, PsycInfo, So-

cial Science Citations Index and Google Scholar for all

qualitative studies investigating health care professionals’

views on antibiotic prescribing in LTCFs. The quality of

the papers was assessed using the Critical Appraisal Skills

Programme (CASP) assessment tool for qualitative re-

search. Thematic synthesis was used to integrate the

emergent themes into an overall analytical theme.

Results The synthesis of eight qualitative studies indi-

cated that health care professionals and administrators have

identified factors that influence antibiotic prescribing in

LTCFs. These factors include variations in knowledge and

practice among health care professionals, and the LTCF

context, which is unique given the complex patient

population and restricted access to doctors and diagnostic

tests. The social factors underpinning the interaction be-

tween nurses, residents’ families and doctors also influence

decision making around antibiotic prescribing. The study

also found that there is an acknowledged need for col-

laborative, evidence-based AMS specific to LTCFs, as

antibiotic prescribing is heavily influenced by factors

unique to this setting.

Conclusion This review highlighted the key contextual

challenges for AMS in LTCFs. The findings provide an in-

depth insight into the factors—such as the LTCF context,

social factors, variability in knowledge and prescribing

practices, and antimicrobial resistance—that impact on

antibiotic prescribing and AMS strategies. These factors

must be considered in order to ensure the feasibility and

applicability of future AMS interventions.

Key Points

The influences of the long-term care facility (LTCF)

context and social factors have an important impact

on antibiotic prescribing in this setting.

According to the findings of this review, future

antimicrobial stewardship strategies must emphasize

the importance of knowledge of guidelines and

antimicrobial resistance, and the strategies must be

specifically designed for implementation in the

LTCF setting.

1 Introduction

Recent studies evaluating the prescribing of antibiotics in

long-term care facilities (LTCFs) have found that antibiotic

prescribing is common, with reported annual prevalence

rates ranging from 47 to 79 % [1]. As many as 25–75 % of

Electronic supplementary material The online version of this article (doi:10.1007/s40266-015-0252-2) contains supplementary material, which is available to authorized users.

& Aoife Fleming [email protected]

1 Pharmaceutical Care Research Group, School of Pharmacy,

University College Cork, Cork, Ireland

2 Department of General Practice, University College Cork,

Cork, Ireland

Drugs Aging (2015) 32:295–303

DOI 10.1007/s40266-015-0252-2

antibiotic prescriptions in LTCFs are inappropriate in terms

of their indication, dose or duration of therapy [2]. Through

reductions in antibiotic prescribing and encouragement of

appropriate use of antibiotics, the rates of antimicrobial

resistance (AMR) and adverse drug events can be reduced

[3]. The few antimicrobial stewardship (AMS) intervention

studies that have been conducted in LTCFs have reported

modest effects, which were often not sustained [4, 5]. In

order to establish how best to address AMS strategies in

LTCFs, the factors that influence antibiotic prescribing

behaviours must be determined and understood. There is a

need for detailed awareness and understanding of the be-

haviour of all health care professionals involved in LTCF

antibiotic prescribing.

There have been several qualitative review papers

evaluating influences on antibiotic prescribing in primary

and secondary care settings [6–8]. Qualitative studies in-

vestigating antibiotic prescribing in LTCFs have been

conducted, but, to date, there has not been an overall

synthesis of these studies. Synthesis of knowledge is im-

portant to bring together the findings of individual studies

in order to further the understanding of a given issue [9]. A

qualitative meta-synthesis integrates and compares findings

across different studies, and the accumulated knowledge

may lead to development of a new theory, narrative or

interpretive translation [9, 10]. Synthesis of information

from existing qualitative studies may help to contribute to

AMS strategies in LTCFs.

The objective of this qualitative meta-synthesis was to

synthesize the qualitative research findings that have col-

lected health care professionals’ and administrators’ views

of the factors influencing antibiotic prescribing in LTCFs.

2 Methods

2.1 Search Strategy

The following databases were searched from their incep-

tion until July 2014: Embase, PubMed, PsycInfo, Social

Science Citations Index and Google Scholar. The search

strategy that was adopted included the following search

terms: (antibiotic* OR antibacterial* OR infection*) AND/

OR (attitude of health personnel) AND (nursing home* OR

long term care facilit*) AND (interview* OR ‘qualitative

research’). There were no date or language restrictions

imposed. We searched the reference lists of relevant arti-

cles to screen for any relevant studies.

2.2 Study Inclusion Criteria

The studies were included in the review if they met the

following criteria: (1) used qualitative data collection and

analysis methods; (2) were focussed on LTCF antibiotic

use; (3) included health care professionals (doctors, nurses

or pharmacists, or a combination of these groups) or LTCF

administrators in the sample; and (4) used qualitative

methods to evaluate an AMS intervention. In the case of

Did you find apk for android? You can find new and apps.

What Will You Get?

We provide professional writing services to help you score straight A’s by submitting custom written assignments that mirror your guidelines.

Premium Quality

Get result-oriented writing and never worry about grades anymore. We follow the highest quality standards to make sure that you get perfect assignments.

Experienced Writers

Our writers have experience in dealing with papers of every educational level. You can surely rely on the expertise of our qualified professionals.

On-Time Delivery

Your deadline is our threshold for success and we take it very seriously. We make sure you receive your papers before your predefined time.

24/7 Customer Support

Someone from our customer support team is always here to respond to your questions. So, hit us up if you have got any ambiguity or concern.

Complete Confidentiality

Sit back and relax while we help you out with writing your papers. We have an ultimate policy for keeping your personal and order-related details a secret.

Authentic Sources

We assure you that your document will be thoroughly checked for plagiarism and grammatical errors as we use highly authentic and licit sources.

Moneyback Guarantee

Still reluctant about placing an order? Our 100% Moneyback Guarantee backs you up on rare occasions where you aren’t satisfied with the writing.

Order Tracking

You don’t have to wait for an update for hours; you can track the progress of your order any time you want. We share the status after each step.

image

Areas of Expertise

Although you can leverage our expertise for any writing task, we have a knack for creating flawless papers for the following document types.

Areas of Expertise

Although you can leverage our expertise for any writing task, we have a knack for creating flawless papers for the following document types.

image

Trusted Partner of 9650+ Students for Writing

From brainstorming your paper's outline to perfecting its grammar, we perform every step carefully to make your paper worthy of A grade.

Preferred Writer

Hire your preferred writer anytime. Simply specify if you want your preferred expert to write your paper and we’ll make that happen.

Grammar Check Report

Get an elaborate and authentic grammar check report with your work to have the grammar goodness sealed in your document.

One Page Summary

You can purchase this feature if you want our writers to sum up your paper in the form of a concise and well-articulated summary.

Plagiarism Report

You don’t have to worry about plagiarism anymore. Get a plagiarism report to certify the uniqueness of your work.

Free Features $66FREE

  • Most Qualified Writer $10FREE
  • Plagiarism Scan Report $10FREE
  • Unlimited Revisions $08FREE
  • Paper Formatting $05FREE
  • Cover Page $05FREE
  • Referencing & Bibliography $10FREE
  • Dedicated User Area $08FREE
  • 24/7 Order Tracking $05FREE
  • Periodic Email Alerts $05FREE
image

Our Services

Join us for the best experience while seeking writing assistance in your college life. A good grade is all you need to boost up your academic excellence and we are all about it.

  • On-time Delivery
  • 24/7 Order Tracking
  • Access to Authentic Sources
Academic Writing

We create perfect papers according to the guidelines.

Professional Editing

We seamlessly edit out errors from your papers.

Thorough Proofreading

We thoroughly read your final draft to identify errors.

image

Delegate Your Challenging Writing Tasks to Experienced Professionals

Work with ultimate peace of mind because we ensure that your academic work is our responsibility and your grades are a top concern for us!

Check Out Our Sample Work

Dedication. Quality. Commitment. Punctuality

It May Not Be Much, but It’s Honest Work!

Here is what we have achieved so far. These numbers are evidence that we go the extra mile to make your college journey successful.

0+

Happy Clients

0+

Words Written This Week

0+

Ongoing Orders

0%

Customer Satisfaction Rate
image

Process as Fine as Brewed Coffee

We have the most intuitive and minimalistic process so that you can easily place an order. Just follow a few steps to unlock success.

See How We Helped 9000+ Students Achieve Success

image

We Analyze Your Problem and Offer Customized Writing

We understand your guidelines first before delivering any writing service. You can discuss your writing needs and we will have them evaluated by our dedicated team.

  • Clear elicitation of your requirements.
  • Customized writing as per your needs.

We Mirror Your Guidelines to Deliver Quality Services

We write your papers in a standardized way. We complete your work in such a way that it turns out to be a perfect description of your guidelines.

  • Proactive analysis of your writing.
  • Active communication to understand requirements.
image
image

We Handle Your Writing Tasks to Ensure Excellent Grades

We promise you excellent grades and academic excellence that you always longed for. Our writers stay in touch with you via email.

  • Thorough research and analysis for every order.
  • Deliverance of reliable writing service to improve your grades.
Place an Order Start Chat Now
image