Nurses play an important role in influencing culture practices and antimicrobial prescribing, but they are often overlooked in stewardship interventions. How nurses communicate a patient’s condition can impact whether the clinician orders a urine culture and/or prescribes antibiotics. However, prior surveys of nurses have revealed that knowledge related to evidence-based indications for ordering urine cultures may be low. In addition, poor collection techniques may lead to contaminated or false-positive results, further complicating the clinician’s ability to interpret a urine-culture result.
Prior data related to nurse-driven urine-culture practices have primarily focused on assessing knowledge, with little investigation into social, environmental, and cultural barriers that influence these practices. The Capability, Opportunity, Motivation and Behavior (COM-B) model examines the interactions among 3 components: capability, opportunity, and motivation on behavior. In this study, the team applied the COM-B model to understand barriers to and facilitators of evidence-based urine-culture practices (behavior) by nurses in inpatient settings.