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Objectives Inappropriate antibiotic use is a major contributor to antimicrobial resistance. Nursing home (NH) residents are frequently prescribed antibiotics unnecessarily, particularly for urinary tract infections (UTIs)—the most commonly treated infection in this setting. However, studies show that over half of these prescriptions do not meet clinical criteria for a UTI, suggesting substantial overdiagnosis. Such overtreatment may cause more harm than benefit in this vulnerable population.To inform the development of tailored intervention materials for infection prevention and antibiotic stewardship in NHs across eight European countries, we conducted a comprehensive context analysis to identify key challenges and areas for improvement.Method As part of the EU-funded IMAGINE project ( www.imagineproject.eu), three complementary studies were carried out in Denmark, Greece, Hungary, Lithuania, Poland, Slovakia, Slovenia, and Spain:An online questionnaire targeting NH staffStructured in-person qualitative interviews, andAn Infection Prevention and control (IPC) audit of routine care practices.The questionnaire covered practices and beliefs related to infection prevention, UTI diagnosis and management, and antimicrobial stewardship. Interviews explored staff perceptions of factors influencing infection prevention practices antibiotic use. IPC audits assessed availability and use of hygiene-related resources and procedures during personal care tasks.Results A total of 286 NH staff completed the questionnaire, revealing notable differences across countries in training, recognition of UTI symptoms, and perceptions of appropriate antibiotic use. Forty qualitative interviews identified key barriers and facilitators within five thematic areas: the NH environment, staff, physicians, residents, and relatives. The IPC audit included 2,912 observations, documenting significant variability in hand hygiene and use of protective equipment.Conclusions This context analysis highlights both shared and country-specific drivers of inappropriate anti-biotic use in NHs. The findings provide a robust foundation for developing context-sensitive, evidence-informed interventions to improve infection prevention and stewardship practices across European nursing homes.