**Urine dipsticks**

A minority of care staff were aware that they should not be using dipsticks. *"I heard that some of them went for the training* . . . *like six months ago, been* advised *not to follow the urine dip any more."* Care home staff 7 *(Knowledge)*

One stakeholder reported optimism that their work around UTIs, implementing the leaflet and decreasing dipstick use in their region had reduced the amount of urines being bought in to general practice. *"receptionist love me because I stop that wave of urine that used to come in* every *morning, and the nurses said it was taking hours of their time."* Stakeholder 8 *(Optimism)* All general practice staff reported that they have had issues with patients bringing in urine samples to reception for dipping. *"lots of patients just dropping in samples that we never knew what they were for or whether to send it off, so we've tightened up on that."* General practice staff 3 *(Social influence)* Care staff decided to use urine dipsticks as a result of noticing other symptoms. *"we usually notice something else which has caused us to do that test anyway* . . . *so we're not just relying on that."* Care home staff 2

Care home staff felt pressured by GP staff to use and report dipstick results for suspected UTIs. *"they'll ask if you've done a urine dip, you'll say, yeah, you'll have to tell them what it's showing."* Care home staff 4 *(Social influence)* Some clinicians feel pressured by care homes to prescribe antibiotics based on a urine dipstick result. *"Sometimes we get a call from the care homes, they dip the urine and if it is positive and then they want antibiotic."* General practice staff 2 *(Social influence)*

Some care homes intended to keep using urine dipsticks to identify UTIs. *"Because it's worked for us. It seems to have worked, I think that's the hard thing, because it always has seemed to* work *that way."* Care home staff 1 *(Intentions)*
