{"id":"https://openalex.org/W7224136208","doi":"https://doi.org/10.1007/s40520-026-03551-9","title":"Barriers and enablers to implementing antimicrobial stewardship for suspected urinary tract infection in residential aged care: a systematic review","display_name":"Barriers and enablers to implementing antimicrobial stewardship for suspected urinary tract infection in residential aged care: a systematic review","publication_year":2026,"publication_date":"2026-10-28","ids":{"openalex":"https://openalex.org/W7224136208","doi":"https://doi.org/10.1007/s40520-026-03551-9"},"language":"en","primary_location":{"id":"doi:10.1007/s40520-026-03551-9","doi":"https://doi.org/10.1007/s40520-026-03551-9","is_oa":true,"landing_page_url":"https://doi.org/10.1007/s40520-026-03551-9","pdf_url":null,"source":{"id":"https://openalex.org/S107309357","display_name":"Aging Clinical and Experimental Research","issn_l":"1594-0667","issn":["1594-0667","1720-8319"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319900","host_organization_name":"Springer Science+Business Media","host_organization_lineage":["https://openalex.org/P4310319900","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Science+Business Media","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Aging Clinical and Experimental Research","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"hybrid","oa_url":"https://doi.org/10.1007/s40520-026-03551-9","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5130320902","display_name":"Sauravi Chand","orcid":"https://orcid.org/0009-0003-7578-5586","observed_orcids":["https://orcid.org/0009-0003-7578-5586"]},"institutions":[{"id":"https://openalex.org/I120125038","display_name":"Bond University","ror":"https://ror.org/006jxzx88","country_code":"AU","type":"education","lineage":["https://openalex.org/I120125038"]}],"countries":["AU"],"is_corresponding":true,"raw_author_name":"Sauravi Chand","raw_affiliation_strings":["Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia"],"raw_orcid":"https://orcid.org/0009-0003-7578-5586","affiliations":[{"raw_affiliation_string":"Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia","institution_ids":["https://openalex.org/I120125038"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5060457696","display_name":"Elsa Dent","orcid":"https://orcid.org/0000-0002-4006-3992","observed_orcids":["https://orcid.org/0000-0002-4006-3992"]},"institutions":[{"id":"https://openalex.org/I169541294","display_name":"Flinders University","ror":"https://ror.org/01kpzv902","country_code":"AU","type":"education","lineage":["https://openalex.org/I169541294"]}],"countries":["AU"],"is_corresponding":false,"raw_author_name":"Elsa Dent","raw_affiliation_strings":["College of Medicine and Public Health, Rural and Remote Health SA (RRHSA), Flinders University, Adelaide, South Australia, Australia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"College of Medicine and Public Health, Rural and Remote Health SA (RRHSA), Flinders University, Adelaide, South Australia, Australia","institution_ids":["https://openalex.org/I169541294"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5082027026","display_name":"Mark A J Morgan","orcid":"https://orcid.org/0000-0001-7749-2427","observed_orcids":["https://orcid.org/0000-0001-7749-2427"]},"institutions":[{"id":"https://openalex.org/I120125038","display_name":"Bond University","ror":"https://ror.org/006jxzx88","country_code":"AU","type":"education","lineage":["https://openalex.org/I120125038"]}],"countries":["AU"],"is_corresponding":false,"raw_author_name":"Mark Morgan","raw_affiliation_strings":["Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia","institution_ids":["https://openalex.org/I120125038"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5160054624","display_name":"Cindy Jones","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I11701301","display_name":"Griffith University","ror":"https://ror.org/02sc3r913","country_code":"AU","type":"education","lineage":["https://openalex.org/I11701301"]},{"id":"https://openalex.org/I120125038","display_name":"Bond University","ror":"https://ror.org/006jxzx88","country_code":"AU","type":"education","lineage":["https://openalex.org/I120125038"]},{"id":"https://openalex.org/I152743029","display_name":"Kaohsiung Medical University","ror":"https://ror.org/03gk81f96","country_code":"TW","type":"education","lineage":["https://openalex.org/I152743029"]}],"countries":["AU","TW"],"is_corresponding":false,"raw_author_name":"Cindy Jones","raw_affiliation_strings":["College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan","Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia","School of Nursing and Midwifery, Griffith University, Queensland, Australia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan","institution_ids":["https://openalex.org/I152743029"]},{"raw_affiliation_string":"Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia","institution_ids":["https://openalex.org/I120125038"]},{"raw_affiliation_string":"School of Nursing and Midwifery, Griffith University, Queensland, Australia","institution_ids":["https://openalex.org/I11701301"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":4,"corresponding_author_ids":["https://openalex.org/A5130320902"],"corresponding_institution_ids":["https://openalex.org/I120125038"],"apc_list":{"value":4490,"currency":"USD","value_usd":4490},"apc_paid":{"value":4490,"currency":"USD","value_usd":4490},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.85210837,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10897","display_name":"Antibiotic Use and Resistance","score":0.9916999936103821,"subfield":{"id":"https://openalex.org/subfields/2402","display_name":"Applied Microbiology and Biotechnology"},"field":{"id":"https://openalex.org/fields/24","display_name":"Immunology and Microbiology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},"topics":[{"id":"https://openalex.org/T10897","display_name":"Antibiotic Use and Resistance","score":0.9916999936103821,"subfield":{"id":"https://openalex.org/subfields/2402","display_name":"Applied Microbiology and Biotechnology"},"field":{"id":"https://openalex.org/fields/24","display_name":"Immunology and Microbiology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T10629","display_name":"Health Policy Implementation Science","score":0.003000000026077032,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11232","display_name":"Urinary Tract Infections Management","score":0.002300000051036477,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/antimicrobial-stewardship","display_name":"antimicrobial stewardship","score":1.0},{"id":"https://openalex.org/keywords/urinary-tract-infection","display_name":"urinary tract infection","score":0.9750000238418579},{"id":"https://openalex.org/keywords/nursing-homes","display_name":"nursing homes","score":0.878000020980835},{"id":"https://openalex.org/keywords/implementation-barriers-and-facilitators","display_name":"implementation barriers and facilitators","score":0.9010000228881836},{"id":"https://openalex.org/keywords/older-adults","display_name":"older adults","score":0.6010000109672546},{"id":"https://openalex.org/keywords/staff-knowledge-and-confidence","display_name":"staff knowledge and confidence","score":0.8180000185966492},{"id":"https://openalex.org/keywords/clinical-decision-support","display_name":"clinical decision support","score":0.7350000143051147},{"id":"https://openalex.org/keywords/leadership-support","display_name":"leadership support","score":0.906000018119812},{"id":"https://openalex.org/keywords/multidisciplinary-collaboration","display_name":"multidisciplinary collaboration","score":0.8550000190734863},{"id":"https://openalex.org/keywords/stakeholder-engagement","display_name":"stakeholder engagement","score":0.7509999871253967}],"concepts":[{"id":"https://openalex.org/C2776040555","wikidata":"https://www.wikidata.org/wiki/Q19903321","display_name":"Antimicrobial stewardship","level":4,"score":0.7149999737739563},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.6043000221252441},{"id":"https://openalex.org/C2779343474","wikidata":"https://www.wikidata.org/wiki/Q3109175","display_name":"Context (archaeology)","level":2,"score":0.5855000019073486},{"id":"https://openalex.org/C2780984029","wikidata":"https://www.wikidata.org/wiki/Q2930198","display_name":"Stakeholder engagement","level":2,"score":0.46399998664855957},{"id":"https://openalex.org/C22467394","wikidata":"https://www.wikidata.org/wiki/Q849359","display_name":"Multidisciplinary approach","level":2,"score":0.45739999413490295},{"id":"https://openalex.org/C201305675","wikidata":"https://www.wikidata.org/wiki/Q852998","display_name":"Stakeholder","level":2,"score":0.44850000739097595},{"id":"https://openalex.org/C189708586","wikidata":"https://www.wikidata.org/wiki/Q1504425","display_name":"Systematic review","level":3,"score":0.42800000309944153},{"id":"https://openalex.org/C2778139618","wikidata":"https://www.wikidata.org/wiki/Q13440398","display_name":"Workforce","level":2,"score":0.414900004863739},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.4047999978065491},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.3880999982357025},{"id":"https://openalex.org/C2777950569","wikidata":"https://www.wikidata.org/wiki/Q17021836","display_name":"Stewardship (theology)","level":3,"score":0.38749998807907104},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.3736000061035156},{"id":"https://openalex.org/C109359841","wikidata":"https://www.wikidata.org/wiki/Q728944","display_name":"Inclusion (mineral)","level":2,"score":0.34689998626708984},{"id":"https://openalex.org/C194051981","wikidata":"https://www.wikidata.org/wiki/Q1337691","display_name":"Economic shortage","level":3,"score":0.30000001192092896},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.29739999771118164},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.2973000109195709},{"id":"https://openalex.org/C2781145037","wikidata":"https://www.wikidata.org/wiki/Q5011772","display_name":"CINAHL","level":3,"score":0.2973000109195709},{"id":"https://openalex.org/C46304622","wikidata":"https://www.wikidata.org/wiki/Q374814","display_name":"Certification","level":2,"score":0.2944999933242798},{"id":"https://openalex.org/C2780233487","wikidata":"https://www.wikidata.org/wiki/Q6672123","display_name":"Long-term care","level":2,"score":0.28209999203681946},{"id":"https://openalex.org/C2779530757","wikidata":"https://www.wikidata.org/wiki/Q1207505","display_name":"Quality (philosophy)","level":2,"score":0.28139999508857727},{"id":"https://openalex.org/C206345919","wikidata":"https://www.wikidata.org/wiki/Q20380951","display_name":"Resource (disambiguation)","level":2,"score":0.2782999873161316},{"id":"https://openalex.org/C141330323","wikidata":"https://www.wikidata.org/wiki/Q2354820","display_name":"Evidence-based practice","level":3,"score":0.2754000127315521},{"id":"https://openalex.org/C2780182762","wikidata":"https://www.wikidata.org/wiki/Q1630279","display_name":"Guideline","level":2,"score":0.2565000057220459},{"id":"https://openalex.org/C47177190","wikidata":"https://www.wikidata.org/wiki/Q207137","display_name":"Curriculum","level":2,"score":0.2556000053882599}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1007/s40520-026-03551-9","doi":"https://doi.org/10.1007/s40520-026-03551-9","is_oa":true,"landing_page_url":"https://doi.org/10.1007/s40520-026-03551-9","pdf_url":null,"source":{"id":"https://openalex.org/S107309357","display_name":"Aging Clinical and Experimental Research","issn_l":"1594-0667","issn":["1594-0667","1720-8319"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319900","host_organization_name":"Springer Science+Business Media","host_organization_lineage":["https://openalex.org/P4310319900","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Science+Business Media","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Aging Clinical and Experimental Research","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.1007/s40520-026-03551-9","doi":"https://doi.org/10.1007/s40520-026-03551-9","is_oa":true,"landing_page_url":"https://doi.org/10.1007/s40520-026-03551-9","pdf_url":null,"source":{"id":"https://openalex.org/S107309357","display_name":"Aging Clinical and Experimental Research","issn_l":"1594-0667","issn":["1594-0667","1720-8319"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319900","host_organization_name":"Springer Science+Business Media","host_organization_lineage":["https://openalex.org/P4310319900","https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Science+Business Media","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Aging Clinical and Experimental Research","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.98580002784729,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/systematic-review","display_name":"Systematic Review"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2981437965","https://openalex.org/W3131937000","https://openalex.org/W7203768694","https://openalex.org/W7203896594","https://openalex.org/W4388124647","https://openalex.org/W7140059942","https://openalex.org/W4391902803","https://openalex.org/W3155105898","https://openalex.org/W4289455779","https://openalex.org/W1980568742"],"abstract_inverted_index":{"Abstract":[0],"Background/Objective":[1],"Despite":[2],"the":[3,37,95,104,110,190],"importance":[4],"of":[5,16],"antimicrobial":[6],"stewardship":[7],"(AMS)":[8],"in":[9,51,79,146,202,248],"residential":[10],"aged":[11],"care":[12],"homes":[13],"(RACHs),":[14],"implementation":[15,198,247],"AMS":[17,74,197,246],"for":[18,76,199],"suspected":[19,77,200],"urinary":[20],"tract":[21],"infections":[22],"(UTIs)":[23],"remains":[24],"inconsistent.":[25],"This":[26,43],"review":[27,45],"synthesised":[28,99],"reported":[29,50,224,235],"barriers":[30,69,128],"and":[31,33,49,90,101,123,132,143,149,155,164,175,181,185,209,219,230,244],"enablers":[32,71,160],"mapped":[34,102],"them":[35],"to":[36,62,72,103,169],"Theoretical":[38],"Domain":[39],"Framework":[40],"(TDF).":[41],"Methods":[42],"systematic":[44],"followed":[46],"JBI":[47],"guidelines":[48],"accordance":[52],"with":[53],"PRISMA":[54],"2020.":[55],"Five":[56],"databases":[57],"were":[58,81,98,188,222,233],"searched":[59],"from":[60,113,141],"inception":[61],"12":[63,107],"February":[64],"2026.":[65],"Studies":[66],"explicitly":[67],"reporting":[68],"and/or":[70],"implementing":[73],"strategies":[75],"UTIs":[78],"RACHs":[80,203],"included.":[82],"Two":[83],"reviewers":[84],"independently":[85],"screened":[86],"studies,":[87],"extracted":[88],"data,":[89],"assessed":[91],"methodological":[92],"quality":[93],"using":[94],"MMAT.":[96],"Findings":[97],"inductively":[100],"TDF.":[105],"Results":[106],"studies":[108],"met":[109],"inclusion":[111],"criteria":[112],"1130":[114],"records":[115],"identified":[116],"through":[117],"database":[118],"searches,":[119],"supplemented":[120],"by":[121,206],"citation":[122],"trial":[124],"registry":[125],"searches.":[126],"Common":[127],"included":[129,161],"workforce":[130],"instability":[131],"limited":[133,156],"resources,":[134],"reliance":[135],"on":[136],"established":[137],"practice,":[138],"social":[139,214],"pressure":[140],"clinicians":[142],"families,":[144],"gaps":[145,221],"staff":[147,162],"knowledge":[148,220],"confidence,":[150],"concerns":[151],"about":[152,217],"negative":[153],"consequences,":[154,218],"stakeholder":[157],"engagement.":[158],"Key":[159],"education":[163],"training,":[165],"multidisciplinary":[166],"collaboration,":[167],"access":[168],"clinical":[170],"decision-support":[171],"tools,":[172],"leadership":[173,228],"support,":[174,229],"organisational":[176],"policy":[177,231],"alignment.":[178],"Environmental":[179],"Context":[180],"Resources,":[182],"Social":[183],"Influences,":[184],"Behavioural":[186],"Regulation":[187],"among":[189],"most":[191],"commonly":[192,234],"represented":[193],"TDF":[194],"domains.":[195],"Conclusion":[196],"UTI":[201],"is":[204],"influenced":[205],"multiple":[207],"contextual":[208],"behavioural":[210],"determinants.":[211],"Resource":[212],"constraints,":[213],"pressure,":[215],"beliefs":[216],"frequently":[223],"barriers,":[225],"whereas":[226],"education,":[227],"alignment":[232],"enablers.":[236],"Addressing":[237],"these":[238],"determinants":[239],"may":[240],"facilitate":[241],"more":[242],"effective":[243],"sustainable":[245],"RACHs.":[249]},"counts_by_year":[],"updated_date":"2026-11-05T12:25:35.769452","created_date":"2026-10-29T00:00:00"}
