Nordic research network on infection control

SARS-CoV-2 in hospital air and airborne transmission of SARS-CoV-2 in housholds.

Previous research on sources of norovirus in hospital air and potential airborne transmission of norovirus during hospial outbreaks. Current investigations in sources of airborne SARS-CoV-2. Evaluation of infection control efforts to prevent and mitigate hospital transmission of SARS-CoV-2.

Project leader: Jakob Löndahl, Carl-Johan Fraenkel

Group Members: Carl-Johan Fraenkel, Jakob Löndahl, Malin Alsved, Patrik Medstrand

Contact: Carl-Johan.Fraenkel@skane.se

Clostridioides difficile: preventive strategies

Clostridioides difficile infections are among the most common infections associated with hospital care.

Project leader: Gunnar Jacobsson

Group members: Maria Werner, Kristina Rizzardi, Ingemar Qvarfordt, Johan Karp, Michael Toepfer.

Contact: jon.edman@vgregion.se

Drivers of COVID19 vaccine hesitancy among  nursing staff in long-term care facilities in Finland  

Introduction

The reasons for vaccine hesitancy, reluctance, or outright refusal are multifaceted and context-specific. This is a qualitative research study that aimed to understand factors influencing COVID-19  vaccine hesitancy and refusal among nursing staff in long-term care facilities in Finland. The study relies on the “ Theoretical domains framework” to understand behavior. 

Methods

 The data was collected through qualitative phone-based interviews among the nursing staff and the management in Spring 2021 and 2022. Respondents were recruited during COVID19 outbreak investigations and through infectious disease doctors of the municipalities. Analysis was based on thematic analysis using NVIVO. The sample included 15 nursing staff members and 20 managers.

The findings of the study will be used to develop context-specific vaccine demand creation plans and strategies for future epidemics and pandemics.  

Project leader: Anna-Leena Lohiniva

Group Members: Jaana-Marija Lehtinen, Hanna Nohynek, Outi Lyytikäinen  

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Exploring behavioral factors influencing COVID-19 specific infection prevention and control measures in Finland

Healthcare worker (HCW) compliance with infection prevention and control (IPC) measures plays a critical role in preventing SARS-CoV-2 spread in healthcare settings. To ensure optimal adherence to COVID-19specific IPC practices, there is a need to understand the factors that influence them.

Objectives

This two-phased study aims to identify and explain factors that influence the compliance to COVID-19 specific IPC measures among nursing staff in long-term care facilities (LTCF) in Finland. The first phase focused on exploring IPC measures generally whereas the second study is focusing on the use of personal protective equipment.

Methode

Both phases include a web-based survey and a qualitative research study based on the Theoretical Domains Framework (TDF); a conceptual 14 domains that can explain behavior.   

Survey

The questions in the surveys covered background information of the respondent and LTCF as well as behavioral factors. The link to the anonymous surveys is distributed to the LTCFs through regional IPC experts and authorities. The outcome is modeled using both ordinary logistic regression and penalized ridge logistic regression using regrouped explanatory variables and the

The original more correlated set of explanatory variables, respectively.

Qualitative interviews

The in-depth interviews are conducted to explain factors that are identified in the survey as factors that influence compliance with IPC measures. A question guide is drafted with semi-structured questions. The subjects are recruited from those who participate in the survey.  Interviews are phone-based lasting from 30 minutes to 60 minutes each. Data is analysed thematically using NVIVO.  

Results of the phase one  

A total of 422 HCWs from 17/20 regions responded to the survey. The study findings suggested that three TDF domains influence the compliance with COVID-19 specific IPC measures: environmental factors and resources (inadequate staffing), beliefs about capabilities, and reinforcement (follow up and feedback of the management). The qualitative study included 20 HCWs consisting of nurses and assistant nurses who provided care in LTCFs during the pandemic. The study identified two themes that explain environmental factors and resources; lack of planning for emergencies; changing work responsibilities. Beliefs in capabilities were linked with knowledge, resources, and responsibilities, and reinforcement was linked with management absence and culture.     

The study provided insights into TDF domains that can be used to develop evidence-based behaviour change interventions and strategies to support HCW compliance with pandemic-specific IPC measures in LTCFs during future epidemics.

This is a two-phase study. The first phase was conducted from November 2020 to May 2021. The second one is being conducted from January 2022 to September 2022.  

Project leader: Anna-Leena Lohiniva

Group members: Jaana-Marija Lehtinen, Saija Toura, Jukka Olgren, Dinah Arifulla, Outi Lyytikäinen

Contact: anna-leena.lohiniva@thl.fi

Association between socioeconomic factors and success of decolonization treatment among individuals diagnosed with methicillin-resistant Staphylococcus aureus: a cohort study from 2007 to 2020

Increased rates of methicillin-resistant Staphylococcus aureus have been reported among populations with low socio-economic status in high-income western countries, e.g. in populations who recently immigrated or who live in deprived neighborhoods. To limit the individual disease burden and transmission to vulnerable populations socioeconomic factors associated with successful decolonization treatment are imported to examine. We examined the association between socioeconomic factors and decolonization treatment in 2,536 patients diagnosed with MRSA for 13 years in a high-income setting (Danish region of 1.2 mills. inhabitants) with free access to the healthcare system. MRSA care was handled in primary health care by general practice staff. 

Project leader: 
Mette Assenholm Kristensen, https://orcid.org/0000-0001-8676-6661
Jens Kjølseth Møller, https://orcid.org/0000-0002-5547-5498

Group members: 
Hanne Irene Jensen, https://orcid.org/0000-0001-9323-4284 
Christian Backer Mogensen, https://orcid.org/0000-0002-8254-089X
Jens Søndergard, https://orcid.org/0000-0002-1629-1864

Contact: Mette.Assenholm.Kristensen@rsyd.dk

Nurses’ attitudes and self-efficacy regarding infection prevention and antibiotic stewardship in the COVID-era – a mixed methods longitudinal study 

The study will describe nurses' attitude and self-efficacy related to infection prevention and antibiotic stewardship in work with patients with multidrug resistant bacteria.In addition, the study will provide increased knowledge about the effects the COVID-19 pandemic on nurses' attitudes and self-efficacy concerning infection prevention and antibiotic stewardship. 

Project leader: Marte Johanne Tangeraas Hansen 

Group members: Anne Marie lunde Husebø, Marianne Storm og Heidi Syre

Contact: marte.johanne.tangeraas.hansen@sus.no

The social patterning of Covid-19 vaccine uptake in older adults: A register-based cross-sectional study in Sweden

The research project is a part of the Swedish Covid-19 Investigation for Future Insights – a Population Epidemiology Approach using Register Linkage (SCIFI-PEARL): Swedish Covid-19 Investigation for Future Insights – a Population Epidemiology Approach using Register Linkage (SCIFI-PEARL) | University of Gothenburg (gu.se)

Contact: malin.spetz@vgregion.se